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What Can I Do If My Worker’s Comp Claim Is Rejected Or Not Paid?

What Can I Do If My Worker’s Comp Claim Is Rejected Or Not Paid?

Workers Comp Claim Denials and What to Do Next

Workplace-related illnesses and injuries are usually covered by an employer’s workers’ comp insurance. In most states, the coverage is determined by the average level of risk in a given industry. Unfortunately, in some cases, worker’s comp insurance claims can be denied for reasons such as:

  • Failure to report an injury in time
  • Failure to file a claim in time
  • Employer disputing the claim
  • The injury may not be compensable
  • Lack of evidence that an injury is work-related
  • Discrepancies between initial medical records and the accident report

All in all, the reason for which a claim is denied must be provided in writing.

What to Do

workers comp claim denial in Belleville Illinois

If your workers’ comp insurance claim has been denied, you do not have to give up. You should carefully read the letter elaborating the reasons why your claim was denied. If your claim has been rejected for a simple matter such as mistaken paperwork, you can contact the claims adjuster to see if the problems can be cleared up. However, unless the insurance company or your employer made a bona fide mistake, this approach is unlikely to be successful, and you may have to appeal the rejected claim.

Appealing a Rejected Workers Comp Claim

The letter informing you about the claim denial may also explain how you can appeal the decision. You should, therefore, read it carefully. The process of appeals varies from one state to another, but generally, the first level involves a hearing before an administrative law judge. At this level, you have to present evidence to support your claim. The hearing can also go through your state’s board of workers compensations or the state’s labor department. There are other levels of appeals beyond the administrative levels, which also vary from one state to another.

When to Find Legal Help

Whether you should find a lawyer or not really depends on the reason for the workers’ comp claim denial. If your claim was rejected for simple matters that can be cleared immediately through the claim adjuster, then you may not need a lawyer. However, if the rejection is due to more complex reasons, then you may need a workers’ comp lawyer. An attorney can help you to determine whether filing an appeal is the appropriate thing to do. Lawyers understand the ins and outs of workers compensation laws, and therefore, a good attorney will stop at nothing to ensure that you get justice. If you are looking for reliable workers’ comp lawyers in Belleville, IL, you can count on Bement Stubblefield, LLC to get the job done.

workers comp claim attorney in Belleville Illinois



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