Workers’ compensation is supposed to help us cover medical bills and lost wages after a work-related injury. But sometimes, the claim gets denied even when people are truly hurt. This seems frustrating and unfair. This happens to people with valid injuries—people who followed the rules but still got turned away.

If you are facing cases like these, workers’ compensation attorneys at Hasner Law can help you understand your rights and what to do next. In this article, we’ll walk through the practical steps to take if your workers’ compensation claim has been denied.

Understanding Why Your Claim Was Denied

After receiving a denial, your first step should be to understand why. Insurance companies deny claims for various reasons. These can include:

Filing your claim late.
Not having enough medical proof to support your injury.
Your employer disagrees that the injury happened at work.

The denial letter you received holds important clues. Read it very carefully. It should explain the exact reasons for the denial. Sometimes, the denial is due to a simple mistake, like a typo or missing information. These are minor errors. Other times, the denial points to more serious issues with your claim. Understanding the difference is key to knowing how to respond.

Reviewing and Gathering Supporting Evidence

Strong evidence is key to overturning a denial. Include detailed medical records—doctor’s notes, test results, and treatment plans must match your injury claims. If your records are inconsistent, insurers may doubt your case.

Collect witness statements, accident reports, and employer records to support your story. Make sure every document ties your injury to work. A vague or disputed connection often leads to denial. The more proof you have, the stronger your appeal will be.

Filing an Appeal: The Next Step After Denial

After a denial, you usually have a limited time to appeal—often 30 to 60 days, depending on your state. Missing this deadline means starting over, so act fast.

File your appeal with your state’s workers’ compensation board, including your denial letter, new evidence, and a clear argument. Avoid rushed or incomplete forms—errors here can sink your case.

The review process may take weeks or months. Some states require mediation first, while others schedule a hearing. Stay organized and patient.

Legal Representation and When to Seek It

If your appeal involves complex issues, such as disputed medical opinions or employer retaliation, a lawyer can help. Attorneys know how to challenge insurers, gather expert testimony, and negotiate settlements.

Self-filing works for simple cases, but legal support improves outcomes. Lawyers handle paperwork, represent you in hearings, and spot issues you might miss. Many work on contingency, meaning no upfront costs.

Preparing for Hearings or Mediation

Sometimes, your appeal might involve a hearing or mediation. A hearing is like a mini-trial where you present your case to a judge or hearing officer. Mediation involves a neutral person helping you and the insurance company to reach an agreement.

Prepare and organize all your documents, and think clearly about what happened and how your injury affects you. During these proceedings, stay calm, focused, and respectful. Clearly explain your situation and answer all questions honestly.

(DISCLAIMER: The information in this article does not necessarily reflect the views of The Global Hues. We make no representation or warranty of any kind, express or implied, regarding the accuracy, adequacy, validity, reliability, availability or completeness of any information in this article.)

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