Steps To Take If Your Workers’ Comp Claim Is Denied

People often get injured on the job, but the workers’ compensation program helps with free medical care and a partial wage if you cannot work. Unfortunately, sometimes your employer’s Workers’ Compensation insurer denies a claim. 

You can take the following steps after a workers’ compensation claim denial to get the benefits you’ve earned. If you are seriously injured or just uncomfortable tackling a denial by yourself, work with an attorney from The Florida Firm, Colling Gilbert Wright. We have been protecting injured workers for more than 20 years, and we have earned a stellar reputation for taking excellent care of our clients and achieving outstanding outcomes.

Read the Denial Letter Carefully

There are several reasons why your claim might be denied. The reason the insurer cites should guide your response.

Florida Statutes § 440.185(1) requires you to notify your employer of your injury or work-related illness within 30 days, and you must file a claim for Workers’ Compensation benefits within two years. If you missed these deadlines, the insurer has the right to deny your claim. However, a workers’ compensation lawyer could review your situation, and if there are extenuating circumstances that explain the delay, the insurer might reconsider.

There are other reasons a Workers’ Comp claim might be denied. The insurer might believe the injury is not work-related, is the result of a pre-existing condition, or claim there is insufficient medical evidence of your injury. Responding effectively to the insurer’s concerns can change the coverage decision.

Respond Quickly to Preserve Your Rights 

A denial letter should contain instructions to appeal the decision. Your first step should be to follow those instructions carefully to ensure the insurer has notice of your intent to appeal. 

Then check with your employer and the Worker’s Compensation insurer to confirm that your claim was filed correctly and contained all the appropriate documentation. If the denial was based on an administrative error, correcting that error might result in the insurer issuing a new decision accepting your claim.

If the denial was based on a substantive reason, contact a workers’ compensation attorney at Colling Gilbert Wright immediately. We can help you gather supporting documentation and file a petition requesting benefits. This process usually leads to a mediation and sometimes a hearing, and could result in a reversal of the claim denial. 

Work With Our Workers’ Compensation Attorneys to Contest a Claim Denial

Many legitimate workers’ compensation claims are denied the first time. If this has happened to you, contact an attorney at Colling Gilbert Wright. We can advise you on the best steps to take after a workers’ compensation claim denial. We don’t take fees or expenses from you—if we win, your employer or their insurance company must pay our fees and expenses, so get in touch with us today.