What happens when your workers' compensation claim comes back denied? As an injured employee, you are counting on that financial support to help you with medical bills and other financial losses, and a denied claim can be devastating. Fortunately, you do not have to accept this as the final word. You may have the option to appeal.
Through an appeal, you may be able to continue to fight for the benefits you need and deserve. One of the most important steps in this process is to understand why the claim did not receive approval and determine how you can address the issue in an appeal.
Reasons why insurance companies deny claims
The workers' compensation process is complex, and often, even valid claims come back denied. It is not unusual to have to appeal for workers' compensation benefits, and you may need to do so, even if you believe that you have a very strong, very valid claim. In most cases, the denial letter contains the reason for refusal. Some of the most common reasons for a denied claim include:
- The claimant did not report the injury in enough time.
- The claimant did not file the compensation claim within the appropriate amount of time.
- There was no evidence to prove that the injury is work related.
- It appears that no medical treatment was necessary for the injury.
- The Florida employer is disputing the claim.
- There is no evidence proving that the injury is compensable.
It is frustrating to learn that you will not get the workers' compensation benefits you need. However, a denial is not the end of the road for you, but you may continue to pursue the financial support necessary for your recovery from a work accident. You may find it beneficial to learn how you can move forward with an appeal.
Do you have a rightful claim to workers' compensation benefits?
The intent of workers' compensation benefits is to support workers who suffer injuries or illnesses at work or because of their jobs. This includes injuries from serious accidents, but these benefits may also cover repetitive stress injuries, occupational illnesses and more.
In order to understand if you have a rightful claim to benefits or how you should proceed with an appeal after a denied claim, you may reach out for assistance as soon as possible after your accident or injury. You may be unsure of your rights or how to protect your interests, but you always have the right to know your options.