Workers Comp Claim Denied? Here’s What to Do Next!

There were 2.8 million workplace injuries and illnesses at work in 2018. Most of these were minor injuries like sprains. About 900,000 of these injuries caused workers to miss at least one day of work.

Some of these injuries are severe enough to require an employee to file a workers comp claim. It’s important to know how the process works because many claims are denied.

How does workers compensation work?

Read on to find out.

What is Workers Compensation?

Workers compensation, or workers comp, is a type of business insurance. Most states require that businesses carry workers compensation to protect workers if they’re hurt on the job.

This type of insurance usually covers medical expenses related to the injury. If an employee has to miss time from work, a portion of wages is covered.

The business provides this insurance. In exchange for workers compensation insurance, the worker agrees not to file a lawsuit against the employer.

The Workers Comp Claim Process

How does workers compensation work? A business is mandated by the state to have a certain amount of workers compensation coverage. Businesses usually have to sign up through private insurance companies.

Business owners have to make sure they get the right policy. Different industries have different risks that some insurers won’t cover.

When a worker is injured on the job, they have to report it to human resources or their supervisor immediately.

You’ll get the paperwork to fill out and the business will file a workers compensation claim with their insurance company.

The insurance company will review the paperwork and the claim and decide whether or not to settle the claim. The process will vary by state because each state has its own set of laws around these claims.

If Your Claim is Denied…

Workers compensation claims are denied for a few common reasons. You may have missed a deadline, or you couldn’t prove the injury happened at work.

Remember, it’s up to you to prove that the injury happened at work. You have to report your injury right away and collect as much relevant documentation as possible to support your claim.

If your claim is denied, most insurance companies have an appeals process. You’ll want to consult with an attorney to go over your claim and help you with the appeal. You have to act quickly. Most states have a deadline to file an appeal.

Miss the deadline and your claim is dead.

It’s Important to Understand How Workers Compensation Works

Workers compensation insurance is an important safeguard for businesses and employees. Employees are protected if they get injured on the job. Businesses are protected from costly lawsuits.

How does a workers comp claim work? Businesses are usually required to provide workers comp coverage by the state. If a worker is hurt, it’s up to them to report the injury right away and file a claim.

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