How to Contest a Denied Workers Compensation Claim?
- Dan T. Matrafajlo
- Wed Nov 2016
- Workers Compensation,
It’s bad enough to get hurt on the job. But what happens when your employer or their insurance company denies your workers’ compensation claim? What steps do you need to contest the denial and receive benefits legally due to you?
Unfortunately, denial of workers’ compensation benefits can happen to any injured worker. When Mark Jones fell on the job, he told his supervisor immediately. Mark felt excruciating pain in his lower back. He suffered through the rest of the day. In fact, he showed up to work for the next two days and struggled to do his job.
Finally, Mark decided he could not take the pain any longer. He asked for a medical referral. Mark was shocked when his employer told him they would not pay for a doctor. The big boss reminded Mark that he already had a back problem when he started with the company. He even suggested that Mark faked his fall to collect benefits.
Mark tried to use his health insurance to pay for a medical examination. However, when he reported the injury was work-related, the doctor said that he needed authorization from the workers’ compensation insurance company. Mark was beyond frustrated and realized that he needed legal advice from an experienced workers’ compensation attorney.
Steps to Contesting a Denied Workers’ Compensation Claim
There are many reasons why a workers’ compensation claim may be denied. An employer may deny that someone worked for them. They may claim that the injured worker was drunk or high at the time of the accident. A company might also deny to provide benefits if they feel an accident did not occur during the course of employment. These are just some of the basic reasons that workers’ compensation claims are denied.
Whatever the reason for the denial, an experienced workers’ compensation attorney can review the circumstances and take the necessary steps to contest the claim. This includes the following:
- Contact the employer to formally report the accident
- Determine the identity of the workers’ compensation insurance company
- Make sure a formal report has been filed with the workers’ compensation carrier
- File the legal documents to initiate a workers’ compensation court action. This is known as a Claim Petition and must be filed within two years of the date of accident.
- File a motion with the court requesting medical treatment and temporary disability benefits.
Were you injured at work and having problems receiving authorized medical care or reimbursement for lost wages? At the Law Offices of Beninato & Matrafaljo, we have extensive experience handling workers’ compensation claims. Contact us to set up an appointment to discuss your accident.