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Addressing a denied workers’ compensation claim

On Behalf of | Nov 6, 2023 | Workers' Compensation

If you are injured at work or suffer a work-related illness, you may qualify for workers’ compensation benefits and there is a process you can follow to apply.

Injuries and illnesses may include broken bones, spinal injuries, head injuries, and exposure to toxic chemicals, for example.

Workers’ compensation process

First, after you become ill or injured on the job, you should seek medical attention and make the doctor aware that the injury is work-related. It’s important to report the injury to your employer as soon as possible and complete an employee claim form. The claim form should include details about the injury or illness and how it happened.

Your employer will also complete and file a report of the work-related injury or illness. The workers’ compensation insurer will review the claim and either approve it or deny it. If they approve it, you should receive benefits soon after, which may include wages and medical coverage. If they deny the claim, you have an option to appeal their decision.

Addressing a denied claim

If your claim is denied, you should receive a denial letter that outlines the reasons why the claim is not covered. You can file a request for reconsideration with the workers’ compensation board.

It’s helpful to collect any evidence that will help support your claim, including witness statements and medical reports. You will have an opportunity to attend a hearing to present evidence and explain why your claim should be approved. In some situations, you may be asked to complete an additional medical exam.