Workers who are injured or become ill on the job are entitled to workers' compensation benefits to help cover medical bills, rehabilitation costs, and lost wages. However, many such claims are denied.
October 22, 2013 /24-7PressRelease/ -- Common Causes of Workers' Comp Claim Denials
Article provided by Kennedy & Colasurd
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Under both federal and state law, workers who are injured or become ill on the job are entitled to workers' compensation benefits to help cover medical bills, rehabilitation costs, and lost wages. The purpose of the system is to provide workers with peace of mind so they can focus on getting well and getting back to work. Unfortunately, however, far too many legitimate workers' compensation claims are wrongly denied by insurance companies.
Common Causes of Claim Denials
In a typical workers' compensation claim, an injured worker will file a claim and seek evaluation by an approved physician for treatment. After a medical assessment, the insurance company will begin its claims process and will provide a determination of benefits in 30 to 60 days. It is at this point that many claims are denied or delayed.
Some common reasons that an insurer may delay or deny a workers' compensation claim include:
-The injury did not occur at work
-Suspicion of fraud
-Lack of evidence
-The worker did not file a claim or submit to examination by a doctor on time
Of course, just because an insurer denies a claim for one of these reasons does not mean that it was correct. The insurer may have done a poor job investigating the claim or may even be acting in bad faith.
Injured Workers Have Options
Fortunately, if an injured worker disagrees with the evaluation or his injury or believes his claim has been denied wrongfully, he has options. If the insurer will not reconsider the disputed claim, a worker may raise the issue with the state workers' compensation board or even pursue the matter in court.
Some common reasons for disputing a denied workers' compensation claim include:
-Failure by an approved doctor to order the tests necessary to properly diagnose a condition
-The approved doctor is not qualified to treat a specific injury or illness
-The benefit amount provided by the insurer was calculated using the incorrect wage
-The insurer does not recognize part of a worker's illness or injury
A Workers' Compensation Attorney Can Help
If you or someone you love has been injured at work, contact an experienced workers' compensation attorney. A knowledgeable workers' compensation lawyer can assess your case and help you get the benefits you deserve. For more information, contact a workers' compensation attorney today.
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