What to Do If a Workers' Compensation Carrier Denies Your Claim

by Michael Fay on May. 01, 2020

Employment Workers' Compensation Accident & Injury Accident & Injury  Personal Injury 

Summary: A brief explanation of how to go about fighting a denied workers' compensation claim.

If you suffer an on-the-job injury, what would you do? If you work for an employer that offers workers' compensation insurance -- which most do -- you would most likely file a claim as instructed. What happens, though, if your provider denies your claim? Sadly, this is something that numerous Minnesota residents have experienced over the years.

The purpose of workers' compensation benefits is to protect employers and ensure that injured employees get the help that they need when they need it. Unfortunately, as is true to form for most insurance companies, workers' comp providers are more concerned with protecting their bottom line than making sure injured workers get medical treatment and appropriate compensation.

Why do insurance companies deny some claims?

There are various reasons as to why a workers' comp provider will deny a claim. Some of these include:

  • Failure to report the injury in the appropriate time frame
  • Failure to file a claim in the necessary time frame
  • Employer disagrees with the claim
  • Injury is not deemed compensable
  • Injury does not require medical treatment
  • Lack of evidence that the injury occurred while on the job

If you receive notice that your provider is denying your claim, the reason as to why should be included in your denial notice.

I received a denial notice, now what?

If your provider denied your claim and you disagree with the decision, you do not have to just sit by and accept it. You have the right to appeal the decision. The sooner you appeal this decision the better. 

Don't go it alone

If you choose to appeal, there is more to it than just sending in a written request. The insurance company is likely going to stand by its decision unless you can provide sufficient evidence that the insurance company wrongly denied your claim. In some cases, court hearings are required and, in others, the issue can be resolved through out-of-court negotiations. In either case, it can be a rather complicated process.

Going to bat against an insurance company without the right help does not often produce desirable results. If you feel it is in your best interest to appeal your denied workers' compensation claim, an experienced attorney can assist you in doing so.

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