Reasons for Workers’ Compensation Claim Denials
Reasons for Workers’ Compensation Claim Denials
Experiencing an injury on the job can be life-changing, and it is important for your workers’ compensation claims to be processed in a timely manner so you can get on with your life. Claim denials can be difficult to deal with or understand. This highlights the value of a workers’ compensation attorney like Matt Matthews, who can assist after a denial. There are a variety of reasons why your claim might be denied, and upon denial, you must follow the legal appeals process to continue the pursuit of your claim.
Read on to learn why your workers’ compensation claim might be denied, and how an attorney can help.
Main Reasons for Workers’ Compensation Denials
Insurance companies can find many reasons to try to deny a claim, including:
- A lack of sufficient evidence the injury was work-related
- Failing to follow a treatment plan
- Missing work and medical treatment were unnecessary
- Failing to properly report an injury and file a claim on time
Sometimes, you can address the reason for the denial, such as insufficient evidence, and they might reverse the denial. An attorney can identify how to best respond to the denial to increase your chances of being granted benefits.
Appealing Your Denial
Most states have an administrative process that involves appealing a claim denial with the state workers’ compensation board or department. However, Alabama is different, and there is no such internal process for appeals. Instead, you must file a lawsuit in state civil court to appeal the overall decision.
If you only need to appeal a denial of certain medical benefits, you might appeal to the Ombudsman Program with the Alabama Department Labor so they can mediate the matter before you head into court. However, if the insurance company does not agree to mediation, this program cannot decide disputes over non-medical issues with your claim.
Filing a lawsuit in civil court is a complicated process with many rules, laws, and procedures that apply. It is critical that you have the right legal assistance during this process.
A Workers’ Compensation Attorney Can Help you Navigate the Process
A delay or denial of your workers’ compensation benefits can seem like it puts your life on pause, and medical bills and treatment costs might still continue adding up while your claim processes. The appeals process is best supported through the assistance of an experienced and knowledgeable personal injury attorney with experience in workers’ compensation cases.
The right attorney will know the steps to take following a denial, so you can continue focusing on your physical recovery and getting back to work. Never give up on the benefits you deserve - make sure you have the right legal help if your claim is denied.
Reach Out to a Montgomery Workers’ Compensation Attorney About Your Claim Today
If you are having difficulty processing your workers’ compensation claim or related denials, an experienced workers’ compensation attorney from the Law Office of Richard F. Matthews, Jr. is here to help. Visit our site to book a consultation on your case today.
The information you obtain at this site is not, nor is it intended to be, legal advice. You should consult an attorney for advice regarding your individual situation. We invite you to contact us and welcome your calls, letters and electronic mail. Contacting us does not create an attorney-client relationship. Please do not send any confidential information to us until such time as an attorney-client relationship has been established. These recoveries and testimonials are not an indication of future results. Every case is different, and regardless of what friends, family, or other individuals may say about what a case is worth, each case must be evaluated on its own facts and circumstances as they apply to the law. The valuation of a case depends on the facts, the injuries, the jurisdiction, the venue, the witnesses, the parties, and the testimony, among other factors. No representation is made that the quality of the legal services to be performed is greater than the quality of legal services performed by other lawyers.
The Law Office of Richard F. Matthews, Jr. serves Montgomery County, Pike County, Elmore County, Autauga County, the River Region of Alabama and throughout the State of Alabama, including Montgomery, Troy, Wetumpka Prattville, Selma and Tuskegee. No attorney-client relationship is established by requesting a consultation or emailing Attorney Richard F. Matthews, Jr.. Information submitted in such communication is not privileged and may be subject to disclosure.
