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Denied Workers’ Compensation? 4 First Steps to Appeal

After being injured at work and facing numerous injuries and medical expenses, you go through the long process of filing for workers’ compensation. You are quite optimistic about your claim, you have the proper supporting evidence, there is obvious fault, and there is sufficient medical documentation—”how will this claim ever get denied?” you think to yourself.

A few weeks after you receive a letter from your insurer, “denied” it reads. How is this possible? Well, the unfortunate truth is that every workers’ comp case is different and there are an array of reasons your claim could have been denied.

While we can’t ensure that your claim isn’t going to get denied, we can educate you about some of the steps to take after getting denied workers’ compensation.

4 Steps to Appeal

Here are 4 steps, in order, that you should take if your workers’ compensation claim was denied:

  1. Understand the Reason - Read the denial letter and any attachments to understand the reason for the denial.

  2. Contact the Insurer - Sometimes your case may have been denied over something simple like a missing document or signature. Other times it may be a simple mistake on the insurance company’s part. Either way, speaking with the insurer is a great first step to take because it may allow for a simple resolution in some cases. If you speak with the insurer and find out that they are standing by their denial, you will need to take further steps if you plan on pursuing your claim.

  3. Try to Get the Insurer to Change Their Ruling - Sometimes getting your claim approved after a denial is as simple as asking the insurance company to reconsider their decision. Unfortunately, more often than not, you will need to present new information that changes the outcome of your case, as most of the time the insurer will stand by their original denial.

  4. Hire a Qualified Attorney - The last step listed, but perhaps the most important, is to call an experienced workers’ compensation attorney. Appealing a workers’ compensation claim denial isn’t a walk in the park. There are many different steps and a lot of moving parts that all must come together to result in a favorable outcome. Hiring an attorney will ensure that you have the best shot at getting your case approved. If you already have, or can get, your medical records relating to your claim, it will help the attorney to give you specific advice and get started on your appeal more quickly.

Our Attorneys

Here at Biggam Fox Skinner, we offer personalized attention and aggressive representation. First, we listen, then we fight for the best possible outcome. With decades of experience dealing with insurance companies, we have seen it all. The extensive knowledge we provide will help guide you through your claim, protecting you and your future.

Don’t do it all alone, we are here for you. Call (802) 375-7603 for a free consultation.

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