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Appealing a denied workers’ compensation claim

On Behalf of Fishman & Fishman, LLC | Apr 16, 2020 | Uncategorized |

Suffering an injury on the job can happen in any line of work, even jobs that are not typically considered dangerous. However, when an injury occurs on the job, employees often rely on benefits from a workers’ compensation claim to cover the costs of their treatment and ensure that they receive appropriate income while they recover, among other things.

When an insurer denies a workers’ compensation claim, many injured workers may assume that they must simply bear the burden of the injury and its costs because there is nothing more that they can do. Fortunately, it is possible to successfully appeal a denied workers’ compensation claim with proper preparation and a strong legal strategy.

If you recently received a notice of denial of your workers’ compensation claim, it is important to review the denial and the claim to identify ways you may challenge the decision. Each victim’s circumstances are different, so it is wise to use high-quality legal resources and guidance. This helps to ensure that your rights remain secure throughout the appeal process and your recovery.

Identify the reason for denial

In order to successfully appeal a claim, you must understand why the insurer chose to deny the claim in the first place. Even if the denial seems unjust, working on your strategy from the perspective of the insurer can give you clarity on how to avoid running into the same issues again.

Depending on the nature of your claim and the steps you took before filing it, the reasons for the denial may vary significantly. Once you understand the core issues at hand, you can more effectively work to overcome them.

In some cases, denials occur because of clerical errors somewhere in the filing and review process. Before you spend significant time and energy building an appeal, be sure to consult with your employer, to see if you can resolve the denial by correcting a clerical error.

Understand your deadlines

When an insurer denies a claim, the employee who filed it only has a certain amount of time to appeal the decision. If you wait too long to file your appeal, the fewer options you have. For instance, in many states, workers have 30 days to appeal a denial, but it is crucial for you to research the specific deadlines that apply in your state and in your particular circumstances.

One you understand the time you have to build your appeal and the reasons for the denial, it is time to begin building your legal strategy, if you still wish to appeal. Workers’ compensation appeals tend to get complicated, so you must prepare carefully for an ideal outcome.

If you ave not begun the process of researching and building your appeal, now is the time. Even waiting a day or two may waste valuable time that you cannot recover. Make sure to use strong legal resources to build an appeal that seeks full compensation for your losses and suffering while keeping your rights secure through the process.

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