A denied workers' comp claim is not the end of the road for you | Rosenthal, Levy, Simon & Sosa

A denied workers’ comp claim is not the end of the road for you

When you suffer an injury at work, you know how important it is to secure benefits through a workers’ compensation claim. This financial support is necessary for your recovery and coverage of your post-accident needs, and it can be devastating when your claim comes back denied. Unfortunately, insurance companies are most concerned with protecting their bottom lines above all else.

If a claim does not get approval, it can feel like a setback. It can be confusing and overwhelming when you realize that you won’t get the help you need right away, but there are still options available to you. You can appeal a denied claim and continue your pursuit of the benefits you need to get better and move forward after a workplace accident.

Reasons for denial

There are many reasons why a workers’ compensation insurance company may deny a claim. These companies will strive to pay out as little as possible, which means that injured Florida workers may have to fight for the benefits they need. Some of the most common reasons that insurance providers list when denying a claim include the following:

  • If there is any indication that you did not report the injury on time to your supervisor, it may result in a denial.
  • When there is not enough evidence that an injury is related to a person’s work, it could lead to a denied claim.
  • If you did not need medical treatment or you did not include enough medical evidence, the insurer may reject your claim.
  • Your claim may not be successful if your employer disputes the claim or is disputing the events that led to your injuries.
  • When a claim is not filed before the deadline, it will likely lead to a denial.

The insurance company should list the reason for the denied claim in a letter to you. When you understand why the claim came back denied, you can then move forward with the next appropriate step. You have the right to appeal.

What’s next?

After a denied claim, you may want to speak with an experienced workers’ compensation attorney regarding the legal options available to you. If an appeal is appropriate, you can get the guidance you need to continue fighting for the full amount of benefits you deserve. An assessment of your case can help you understand why the claim was rejected and what’s next for you.

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