October 27, 2011
/24-7PressRelease/ -- What to do When Your Claim is Denied
Waiting to hearing about your workers' compensation claim can be frustrating. It's even worse when your claim is ultimately denied. If you have received a denial notice, or some time has passed since your claim was filed and you haven't received a response, it's time to be proactive.
First, call the claim adjuster. The phone number will be on your denial notice, or on other paperwork related to your claim. Ask to speak directly to the adjuster in charge of your claim and ask where your claim is in the process.
If your claim has been denied, ask for the specific reasons for the denial. Sometimes, it's simply a matter of the adjuster not having enough information. You can fill in the data gaps over the phone or by sending additional paperwork once you know what they need.
If your conversation with the claims adjuster doesn't resolve the problem, you can call the Minnesota Department of Labor and Industry and ask to speak to an alternative dispute resolution specialist, who can help you figure out the best way to resolve the claim.
The Department of Labor and Industry also has a mediation service in which a trained mediator will work with the claimant and the insurer to come to a mutual agreement about resolution of the case.
You can also try to resolve the claim by filing an Employee Claim Petition form. This form requires very specific information about the claim and the type of benefits you are seeking. It also requires additional information, such as a doctor's report, to be filed with the petition.
Once the petition is properly filed, it must be officially served on the defendants (the employer and the insurer) according to Minnesota law. Then a formal hearing will be scheduled and a settlement conference may be held. You should consult with an experienced workers' compensation attorney for help if you decide to enter this more formal process of claim resolution.
Finally, if you are a member of a labor union or work in the construction industry, there are separate, specific procedures that apply to your claim.
Resolving claim denials can be a complex and time-consuming process. To learn about the available options, speak with an experienced worker's compensation attorney.
Article provided by Reed & Pond LTD
Visit us at http://www.reed-pond.com
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