What Are My Options If My Workers’ Compensation Claim Is Denied?

Mount Laurel Workers’ Comp Claim Denial Attorneys

A workers’ compensation claim is usually denied when the doctor who works for an employer’s insurer decides a worker’s injuries aren’t serious enough or are due to a preexisting condition. Unfortunately, once a workers’ compensation claim is denied, employers typically expect an employee to return to work sooner than he or she is physically ready. As a result, injured employees in this situation are forced to use vacation days or apply for leave under the Family Medical Leave Act (FMLA). Depending on your situation, you may be able to apply for disability benefits, but your employer and doctor will need to fill out part of the application certifying that you are disabled. You’ll also need to fill out the Certification of Contested Workers’ Compensation Claim Form.

A workers’ compensation claim can be denied for different reasons — the claim is filed too late, your employer disputes the claim or your employer’s insurance company doctor rejects your claim for medical reasons.

Filing an Appeal after a Workers’ Compensation Claim Has Been Denied

After a workers’ compensation claim has been denied, you can request a hearing with a Judge of Compensation or with the Division of Workers’ Compensation. In cases in which you have medical bills that need to be paid, you can file a Motion for Medical Temporary Benefits. A hearing with a Judge of Compensation will then be scheduled within 30 days of your motion’s being filed. However, in order to receive temporary benefits, you must be out of work for at least seven days and have a letter from a doctor.

If an insurance company denies your claim or you were provided with reduced benefits, you have only 30 days after that decision to file an appeal. For these reasons, it is essential that you talk to an experienced workers’ compensation attorney as soon as possible. While each case is different, once you appeal a claim denial you may be expected to appear before a board hearing or seek a legal resolution through the court system.

Getting a Second Opinion

If your workers’ compensation claim has been denied, you have a right to get a second opinion from your own doctor. While your company’s insurer is not obligated to accept your doctor’s diagnosis, it makes it more difficult for an employer’s insurer to downplay or ignore the extent and nature of your injuries. Here, you will need to work with an experienced workers’ compensation attorney who can inform your employer’s insurer that you intend to file a lawsuit regarding the denial of your original workers’ compensation claim.

Contact Taylor & Boguski If Your Workers’ Compensation Claim Has Been Denied

Appealing or litigating a denied workers’ compensation claim involves processes, deadlines and careful attention to documents and medical records. At Taylor & Boguski, our workers’ compensation attorneys have the resources and knowledge needed to protect your rights and financial interests when an injury leaves you facing mounting medical bills and an uncertain future. We protect your rights and are prepared to take employers to court when they try to ignore the law or terminate injured employees without cause.

To learn how we can help you, contact Mount Laurel workers’ compensation attorneys at Taylor & Boguski today.