Dealing With A Workers' Comp Claim Denial
While you are very likely covered by workers' comp insurance if you have been injured on the job, the approval for you claim can often go awry for various reasons. Since these benefits are very valuable, namely medical expense coverage and a portion of your lost wages, you can take steps to help ensure that you avoid a denial in the first place. Read on to learn more these denial reasons and the actions to rectify those denials that could push your claim approval through as soon as possible.
Denial due to the presence of drugs or alcohol. While the workplace is not a good place to use drugs or alcohol, the issue in regard to workers' comp coverage is not always as clear. If you report an on-the-job injury, one of the first actions at the doctor's office or hospital emergency room will be a testing of your blood or urine for the presence of certain substances. Unfortunately, these tests may pick up any and all drugs, including legally prescribed medications. If your claim is denied for this reason and you are taking a prescribed medication, showing proof of your prescription could be enough to have your claim reinstated. The presence of alcohol, however, could be a legitimate reason for denial, but not always. In some states the amount of alcohol present in your system at the time of the injury may be determined to be too low to have caused the accident and injury.
Denial due to lack of corroboration. If your injury occurred out-of-sight of others, you may need to take additional steps to find witnesses to verify your account of the accident. Redouble your efforts to locate a witness and other evidence.
1. You may need to reach out to co-workers, even those you don't know, to find a witness. Check with workers in the area or who may have been in the area at the time of your accident.
2. While you're revisiting the scene for witnesses, check for the presence of cameras. These recording devices are plentiful nowadays, and finding one before the evidence is recorded over could help verify your story.
3. Most people recount their accident to other people. If you told your co-workers about your injury right away, you may be able to use them for witnesses. Don't discount using friends and family that you told as well.
Denied for failure to provide a recorded statement to the workers' comp insurance company. You will likely be asked to provide this statement, but you are not required to do so. The insurance company could deny your claim on the basis of "lack of cooperation" or other vague reasons, if you don't comply with this request. You should never provide the insurance adjuster with such a statement without your attorney's support.
If you feel that your workers' comp claim has been unjustly denied for the above or any other reasons, contact a workers' comp attorney immediately. You may need help to get the compensation that you need and deserve as a result of your workplace injury. Contact a lawyer, such as Jack W Hanemann, P.S., for more information.