What Can I Do If I’m Denied Workers’ Compensation Benefits?

Group 152

Table of Contents

When you’re denied workers’ compensation benefits, you’re more than likely feeling defeated. After all, you were likely hoping to be eligible for workers’ compensation benefits to cover the cost of your medical expenses, treatment, and your wage loss. If you’ve recently received a denial of benefits, don’t give up hope. It’s likely that you can have the workers’ compensation insurer change their decision and approve your benefits.

Reaching Out to an Adjuster

If you file the claim and the benefits were denied, whether for medical treatment or wages lost, you should first reach out to your adjuster. Send the adjuster a message via email and let them know you’ve been informed your benefits have been denied. See if they’ll give you a reason as to why they’ve decided to deny your benefits. While the adjuster won’t always respond to this email, it can be beneficial to try in case they do respond. 

If you get a response from the adjuster that explains that your benefits were denied because the adjuster doesn’t believe the treatments are related to the workplace injury or they believe you can go back to work, it’s time to reach out to a workers’ compensation attorney. An experienced workers’ compensation attorney will evaluate your case and let you know all of the benefits you’re entitled to in your case. 

Check to Make Sure All Paperwork Is Correct When Denied Workers’ Compensation Benefits

On the other hand, if the adjuster denies wage loss benefits, it may be because you’re missing paperwork. You may have forgotten to give them a pay stub or a summary of all of the time you missed from work. If you believe this is the case, following up with the adjuster is always good. Add dates and other relevant information in the email so you can create a paper trail. 

Creating a paper trail when working with adjusters is always a good idea. This way, you know when you reached out to them. Make sure to give an adjuster a little time to respond before you reach out to an attorney to see your next steps. If you still haven’t heard back from the adjuster over a week and a half to two weeks, it’s generally a good time to talk to an attorney.

Consider Talking to an Attorney When You’re Denied Workers’ Compensation Benefits

If needed, an attorney can step in for you and file a claim on your behalf. An attorney can also start to step in on your behalf and reach out to the adjuster to keep communication open and see why your benefits were denied. You’ll often see workers’ compensation benefits denied because you haven’t done the required follow-up with the adjuster.

Workers’ compensation insurance sometimes requires authorization to retrieve your medical records. If the insurance company doesn’t have this approval, they’ll deny your benefits because they can’t look to see what your treatments are.

However, if you’ve received a downright denial explaining why the insurance adjuster denied your benefits, it’s time to reach out to an attorney. If you get the direct word that you’ve been denied officially from the adjustment, consoling with an experienced workers’ compensation attorney will give you insight into why your treatment and benefits are actually being denied.

Getting the Workers’ Compensation Approval You Deserve

You’ve gone through enough when you got injured at work. The last thing you should have to worry about is getting approval for your workers’ compensation benefits. If you have a hard time getting approval, don’t hesitate to reach out to our dedicated team of legal professionals. When you’re denied workers’ compensation benefits, contact Mottaz & Sisk Injury Law for a case evaluation today