Employees who are injured on the job are entitled to workers' compensation benefits. You can be reimbursed for lost wages or medical bills. These benefits can pay part of your salary if you become temporarily or permanently disabled. If you can't sue your employer, these benefits may be your only choice. As a result, it is especially devastating if your claim is denied by your employer or insurance company.
By common practice in labor circles, a worker whose workers' compensation claim is rejected needs to receive some letter notifying you of the action. The content of this letter should give you an idea of the best way to respond. You may choose to represent your own appeal or you can seek for a lawyer to do it on your behalf. The second course of action is usually the most advisable form of response. However, it is also possible for an aggrieved employee to request for a hearing before an administrative law judge. In any case though, it is necessary that additional documentation is provided over and above what had been filed at first. Otherwise, your case is likely to be rejected once again.
You can dispute it on your own, if your claim was denied. Or you can choose to have an attorney make sure your claim goes through the proper channels, which could maximize the chances of a successful outcome. An attorney may be able to resolve the dispute and get you the assistance that you need.
By common practice in labor circles, a worker whose workers' compensation claim is rejected needs to receive some letter notifying you of the action. The content of this letter should give you an idea of the best way to respond. You may choose to represent your own appeal or you can seek for a lawyer to do it on your behalf. The second course of action is usually the most advisable form of response. However, it is also possible for an aggrieved employee to request for a hearing before an administrative law judge. In any case though, it is necessary that additional documentation is provided over and above what had been filed at first. Otherwise, your case is likely to be rejected once again.
You can dispute it on your own, if your claim was denied. Or you can choose to have an attorney make sure your claim goes through the proper channels, which could maximize the chances of a successful outcome. An attorney may be able to resolve the dispute and get you the assistance that you need.
There is a host of reasons why a claim can be rejected by the insurers. The key to success is coming into grips with the possibilities and therefore seeking for ways to avoid them. The possible reasons include:
* Lack of adequate evidence
* Lack of a properly performed physical exam
* The claim was filed too late.
* The worker had a pre-existing condition at the time of injury
* There is a suspicion of fraud.
However, insurance companies sometimes do make mistakes and act in bad faith. For example, your workers' compensation claim may have been wrongfully denied because of a pre-existing condition. In fact, when an on-the-job illness or injury affects a pre-existing condition, most employees are entitled to benefits.
The following is a set of tips on what to do if your workers' compensation claim is denied unjustly:
1. Find an attorney who specializes in workers' compensation law. A lawyer may be able to negotiate with insurance companies for you. Attorneys know the laws regarding labor and how they apply to state regulations. Also, you may not have to pay out of pocket because most attorneys are paid from a percentage of the final settlement benefits you win.
2. Ensure that your employer furnishes you with a copy of your personnel file. This will contain a copy of the injury report which you should keep a copy of and send another to the insurance company.
3. Collect as much documentary evidence about your case. This includes all hospital records such as doctor's reports, laboratory test results, records from the emergency room as well as any documents detailing your rehabilitation and recovery. Ensure as well that you have written testimony from any witnesses who were present at the time of the injury. In addition, you need to have documents detailing evidence of expenses like transport to and from doctor's appointments as well as any prescription costs.
4. Ensure that you attend the hearings in person. When it comes to detailing the extent of the injuries, expenses and the amount lost in earnings: ensure you tell the truth as supported by the evidence.
5. Every time the insurer communicates to you, refer the correspondence directly to your attorney. Do not make the mistake of responding yourself no matter how trivial the issue sounds.
6. The insurance company may observe you in public by recording your actions with a video camera.
* Lack of adequate evidence
* Lack of a properly performed physical exam
* The claim was filed too late.
* The worker had a pre-existing condition at the time of injury
* There is a suspicion of fraud.
However, insurance companies sometimes do make mistakes and act in bad faith. For example, your workers' compensation claim may have been wrongfully denied because of a pre-existing condition. In fact, when an on-the-job illness or injury affects a pre-existing condition, most employees are entitled to benefits.
The following is a set of tips on what to do if your workers' compensation claim is denied unjustly:
1. Find an attorney who specializes in workers' compensation law. A lawyer may be able to negotiate with insurance companies for you. Attorneys know the laws regarding labor and how they apply to state regulations. Also, you may not have to pay out of pocket because most attorneys are paid from a percentage of the final settlement benefits you win.
2. Ensure that your employer furnishes you with a copy of your personnel file. This will contain a copy of the injury report which you should keep a copy of and send another to the insurance company.
3. Collect as much documentary evidence about your case. This includes all hospital records such as doctor's reports, laboratory test results, records from the emergency room as well as any documents detailing your rehabilitation and recovery. Ensure as well that you have written testimony from any witnesses who were present at the time of the injury. In addition, you need to have documents detailing evidence of expenses like transport to and from doctor's appointments as well as any prescription costs.
4. Ensure that you attend the hearings in person. When it comes to detailing the extent of the injuries, expenses and the amount lost in earnings: ensure you tell the truth as supported by the evidence.
5. Every time the insurer communicates to you, refer the correspondence directly to your attorney. Do not make the mistake of responding yourself no matter how trivial the issue sounds.
6. The insurance company may observe you in public by recording your actions with a video camera.
1. Find an attorney who specializes in workers' compensation law. A lawyer may be able to negotiate with insurance companies for you. Attorneys know the laws regarding labor and how they apply to state regulations. Also, you may not have to pay out of pocket because most attorneys are paid from a percentage of the final settlement benefits you win.
2. Ensure that your employer furnishes you with a copy of your personnel file. This will contain a copy of the injury report which you should keep a copy of and send another to the insurance company.
3. Collect as much documentary evidence about your case. This includes all hospital records such as doctor's reports, laboratory test results, records from the emergency room as well as any documents detailing your rehabilitation and recovery. Ensure as well that you have written testimony from any witnesses who were present at the time of the injury. In addition, you need to have documents detailing evidence of expenses like transport to and from doctor's appointments as well as any prescription costs.
4. Ensure that you attend the hearings in person. When it comes to detailing the extent of the injuries, expenses and the amount lost in earnings: ensure you tell the truth as supported by the evidence.
5. Every time the insurer communicates to you, refer the correspondence directly to your attorney. Do not make the mistake of responding yourself no matter how trivial the issue sounds.
6. The insurance company may observe you in public by recording your actions with a video camera. If you are caught engaging in any physical activity, it can be used against you. You can even be accused of fraud.
A workers' compensation attorney is able to professionally prepare a case so that a person has a good chance of receiving the support they deserve.
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2. Ensure that your employer furnishes you with a copy of your personnel file. This will contain a copy of the injury report which you should keep a copy of and send another to the insurance company.
3. Collect as much documentary evidence about your case. This includes all hospital records such as doctor's reports, laboratory test results, records from the emergency room as well as any documents detailing your rehabilitation and recovery. Ensure as well that you have written testimony from any witnesses who were present at the time of the injury. In addition, you need to have documents detailing evidence of expenses like transport to and from doctor's appointments as well as any prescription costs.
4. Ensure that you attend the hearings in person. When it comes to detailing the extent of the injuries, expenses and the amount lost in earnings: ensure you tell the truth as supported by the evidence.
5. Every time the insurer communicates to you, refer the correspondence directly to your attorney. Do not make the mistake of responding yourself no matter how trivial the issue sounds.
6. The insurance company may observe you in public by recording your actions with a video camera. If you are caught engaging in any physical activity, it can be used against you. You can even be accused of fraud.
A workers' compensation attorney is able to professionally prepare a case so that a person has a good chance of receiving the support they deserve.
About the Author:
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