Workers compensation is a tricky subject by itself and even more so when you find your claim has been denied. You have worked hard and made sacrifices in your workplace and in the end your request of assistance has been denied. It is annoying, depressing, and may make you think what to do next. However, do not give up now. It is important to know your rights and your choices in this case. This book will take you through the in and outs of workers compensation claims so that you can take back the reigns of your recovery and financial gain process.
Learning the Workers Compensation
Workers compensation is a program which is set up to pay out money and medical care to a worker who is injured at work. It is a kind of safety net as workers can get needed care without having to pay immensely large sums.
These benefits encompass the expenditures incurred such as hospital expenses, rehabilitation and the lost wages in course of recovery. This is one of the protective factors because people can concentrate on getting well instead of being worried of their financial commitment.
All states possess workers compensation laws of their own in regard to workers compensation programs. These are legal acts containing eligibility requirements, the amount of benefits and claim protocols. Employees need to be informed about such regulations of their place.
These claims are normally paid through insurance by employers. Partaking in this program, they not only meet their legal duty, but they also become able to provide a safer work environment to all the involved. Knowing the functioning of this system can make you more empowered in the case of any possible injury or incident at work.
Excuses of Denied Claims
Sometimes it is difficult not to get frustrated when your claim has been rejected, particularly, you have been injured in the workplace. It is important to comprehend the patterns of such choices.
A shortage of medical evidence is one of the key factors of denial. Provided that your documentation is not a clear proof of the connections between your injury and the work you did, the insurance company can deny your claim.
The other reason could be failure to meet deadlines. There are some limitations in the time when a worker should appeal workers compensation claims as per each state. Missing of these windows sometimes lead to auto-rejections.
There are cases where the employers may challenge the occurrence of a case or may argue that it happened during non-work time. This might complicate the situation and also make one feel discarded in case not handled in a proper manner.
Also, preexisting conditions may contribute to the absence of reimbursement. Insurers will interfere that the injury was not necessarily a result of activities at the work place but based on pre existing health conditions.
Being aware of these pitfalls will equip you with the possible challenges in the future.
What to Do In Case Your Claim is Denied
Don not panic after being denied by your workers compensation case. It is possible to do something about the situation.
Start by reading the denial letter especially. It usually gives reasons as to why it is rejected. To know these details may make you plan ahead.
Then collect all the pertinent paper work connected with your injury and work history. This could comprise of medical documents such as the records, the incident reports, and witness statements that could favor your case.
Next, either call your employer or their insurance company to ask about their reasons of denying the claim. Other times misunderstanding can be eliminated easily through open communication.
You may want to appeal should you still think that you are due to get a benefit. In most states, there is some formal procedure involved in this which demanded the extra evidence or argument must be submitted on time.
It is also very essential to maintain thorough notes during the entire process because it will also enable you to establish a solid foundation on which any action you may have to take in future is based.
Finding a Lawyer
Getting a legal assistance may prove helpful when your workers compensation claim is denied. A skilled lawyer will be aware of the intricacy of the workers compensation law and knows how to go through it.
They will answer your case, find out the flaws or gaps in your request, and assist you in collecting facts. This can be in terms of medical reports, eye witness reports or even, expert testimonies on your claim.
It would turn out much better when you have an advocate on your side. They understand how to negotiate with the insurance company and they are ready to take your case to the courts.
Do not be afraid to ask to be helped. A qualified attorney will be able to offer some light during your distressing moment and will make sure that you are well informed on things that you can do. It is okay to remember that you are not alone on this road, professionals are also willing to help you at every step of the way.
Other Ways of Financial Assistance
When your claim to workers compensation claim is being denied do not give up hope. One could look into other options when it comes to funding.
To begin with there is short-term disability insurance. Such kind of coverage may reward you with an income when you are healing due to an injury or disease. Find out whether your employer has it; most employers provide them as an employee benefit.
The other alternative available is the application of Social Security Disability Insurance (SSDI). In case your condition does not enable you to work within a period of one year or more, SSDI may be able to fill the financial gap.
You could also research on personal funds or emergency funding. Although that is not the best route, such resources will offer instant relief in difficult moments.
Charities and local community organizations can also provide their support. Most of the non-profits have programs to relieve people who are currently in temporary bad economic positions due to unexpected events such as work related injury.