5 Questions to Ask If Your Workers’ Compensation Claim Gets Denied

by James M. Hoffmann on Jun. 26, 2018

Employment Workers' Compensation Accident & Injury Employment  Employee Rights 

Summary: If you have had your Missouri workers’ compensation claim denied, there are some instances when that denial can be overturned.

If you are employed in the state of Missouri, you are probably covered by something called workers’ compensation insurance. Worker's compensation helps you to afford what you need in the event you are injured on the job. Although not based on fault, some conditions need to be met for you to be eligible to collect workers’ compensation benefits.


To claim workers’ compensation if you are hurt on the job, you have to start by filing a claim for compensation with the Division of Workers’ Compensation. Once your claim is approved, you should immediately start receiving compensation.


Unfortunately, not all claims are approved. If your claim gets denied, then that does not necessarily mean that there is nothing you can do. Before you think that you are left paying for your injuries due to denial, ask these five critical questions to figure out how to get the ruling overturned.


Under what grounds was your claim denied?


If you received a denial notice, then it should list the reason that your claim was not approved. Depending on what your denial was based, it might be possible to make a case to have it overturned and to receive benefits for your injury.


Was your employer required to have workers’ compensation insurance?


In the state of Missouri, any business that employs more than five workers, or one for the construction industry, is required to carry workers’ compensation insurance. If your employer did not have insurance, then you might be able to pursue a personal injury lawsuit to receive compensation for your injury.


Are you technically considered an employee of the company or business?


There are some work arrangements where people who work for a company are technically not employees. In general, if you receive a W2 tax form, then you are likely an employee and eligible for workers’ compensation. If you are an independent contractor and receive a 1099 tax form, then you are probably not an employee and therefore not eligible for workers’ compensation.


Did you have a qualifying injury according to the guidelines of workers’ compensation coverage?


There are some injuries and illness that are not covered by workers’ compensation benefits. For examples, some pre-existing conditions are not covered by workers’ compensation and some occupational diseases are, likewise, not covered. It is essential to understand how your injury doesn’t qualify and if the insurance company is correct in its determination.


Did you file your claim in time?


In Missouri, there is a limitation of two years post the accident for a worker to claim workers’ compensation. If you miss the statute of limitation for your injury, then it is possible for workers’ compensation to deny your claim.


If you have had your Missouri workers’ compensation claim denied, there are some instances when that denial can be overturned. The best way to know for sure what next steps you should take, is to speak with an experienced St. Louis workers’ compensation attorney to know what you are entitled to and how to go about pleading your case. Give us a call 24/7 at (314)) 361-4300 for a FREE case evaluation.

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