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Was your workers’ comp claim denied? There is still hope

On Behalf of | Jul 20, 2018 | Workers' Compensation

Are you one of the many Kentucky residents who has suffered a work-related injury this year? If you are, you likely did what was necessary, and reported it and filed for workers’ compensation. You went about getting the treatment you needed, believing that insurance will take care of the cost. Then you heard back from insurance and found out your workers’ comp claim did not receive approval. Now what?

Workers’ compensation benefits are in place to protect you from losses experienced as a result of a work-related injury. At least, that is what should happen. Unfortunately, many people find that the coverage they get is minimal if they get anything at all. This leaves them scrambling to cover their financial losses out of pocket.

Why do workers’ comp insurance providers deny claims?

If you filed a workers’ comp claim and it failed to receive approval, your denial letter should explain why. Common reasons for claim denial include:

  • Not filing a claim by the deadline
  • Not reporting the injury by the deadline
  • Medical treatment not thought necessary
  • The injury is not work related
  • Employer denies claim
  • The injury is not compensable

No matter the reason for the denial, receiving word that your claim did not receive approval can be a tough blow, leaving you in a bad way.

If it happens to you

If you did everything right and filed your claim only to find out it did not receive approval, there is still hope for you. Denial is not the end of the road. You have every right to file an appeal. If that is a course of action you wish to pursue, you must file your appeal within a specific time frame — usually 30 days from receiving your denial notice.

To appeal, you need to send a formal request to appeal the decision. With that, you need to include the reason you believe your claim should receive approval and any documentation you have supporting your position. You may have to attend a hearing and present your case in person. If you do, legal counsel can go with you.

The appeals process does not always produce desirable results, but it is certainly worth trying if your workers’ compensation claim fails to receive approval. If filing an appeal does not work, legal counsel can offer guidance on what you can do next. Workers’ compensation benefits protect you if a time comes that you need them. An experienced attorney may be able to help you as you fight for fair and full compensation.