The last thing you want to deal with after experiencing an accident on the job site is warring with the insurance company or your employer to garner your rights to workers’ compensation benefits. This should be a time when you can concentrate on recuperating from your accident, not a time filled with the stress and anxiety that come with a denial of benefits. So what do you do if your employer denies your workers’ compensation claim? Our Charlotte, NC attorneys are here for you at Ted A. Greve and Associates and ready to use their skills and knowledge to help you attain the best outcome possible for your situation.
What are possible reasons my workers’ compensation claim was denied?
The claim was not filed properly or within correct time limits
To begin, it’s important to understand why your claim was potentially denied. One of the most common reasons a claim is denied is that it was not filed in the proper amount of time or it was not reported correctly. It’s best to report your claim immediately, or at least within a matter of days to avoid a claim rejection. When dealing with claims like these, it’s always easiest to try and avoid potential problems such as a time limit. Additionally, after filing the claim, be sure to report it to your employers’ insurance carrier, as well.
Your employer disputed or denied your claim
The second most common reason a claim is denied is because your employer disputes the claim his or herself. There are a variety of reasons a dispute could happen, including that the employer claims that your accident did not happen on the job premises or that your injury or illness is not a direct cause of the accident that did occur. If this is the case, you and your lawyer can gather supporting evidence to show that either your incident did happen on the premises or that your illness or injury is a definite result of the accident at hand. Unfortunately, sometimes employers will deny claims in hopes that their insurance carrier will not have to pay out expenses, which could result in higher premiums for the employer. In these cases, it is also important to have a statement or report from your doctor to support your claims. As a side note, please also always seek the care of a medical professional for any and all workers’ compensation claims. Medical reports are an imperative part of reaching a settlement in cases like these. Additionally, it is important to seek medical help to make sure there are no underlying health issues that might not be apparent directly after your accident.
Your injuries might not be severe enough
Sometimes, a workers’ compensation claim will be denied because the injuries that were reported were not deemed to be severe enough. This is another example of when a medical professional’s exam report is imperative. If your case is denied because of severity issues, contact a workers’ compensation attorney in Charlotte to see what your next steps should be in proving that your case should result in compensation.
If your claim denial does not fall under any of the above circumstances, then it is also important to reach out to a lawyer today so he or she can help you uncover the potential reasons behind why you are not receiving your workers’ compensation benefits.
What are my next steps after I receive my workers’ compensation denial letter?
Read the denial letter in detail
The first thing to do if you receive a letter about your workers’ compensation denial is to read the letter thoroughly. Many times, this letter will explain why your claim was denied, and also tell you how to go about filing an appeal for the claim. Take care to read the letter thoroughly and note any deadlines so that if you need to file an appeal, you can do so well within the suggested time frame.
Contact your employer and/or the insurance company
After this, a smart first step is to contact your employer and the associated insurance company and ask for more details on why the claim was denied. Sometimes, a claim denial is a simple matter of misfiled paperwork or some other type of fixable mistake. If this is the case, it is typically an easy adjustment that will get you back on track in receiving your workers’ compensation benefits. If this is not the case, and if you have not contacted a workers’ compensation attorney in Charlotte, this is a good time to do so, as filing a legal appeal might be in your future.
File an appeal
Just because you received a letter of denial regarding your workers’ compensation claim does not mean this is the end of the road for you. Filing an appeal is always an option, particularly if you have a lawyer on your side to fight for your rights and compensation.
During the appeal process, a hearing involving an administrative law judge with the North Carolina Industrial Commission will take place, where the judge will review medical and factual evidence that you and your attorney have put together. This evidence should support the claim that you were either hurt on the job site or have developed a disease or disability that is a direct effect of a job-related incident. After the presentation of evidence, the judge will make his or her decision on whether or not your appeal is granted.
Meet with a Workers’ Compensation Attorney for a Consultation in Charlotte
If you’re in need of a workers’ compensation attorney in Charlotte, then do not hesitate to reach out to us today at Ted A. Greve and Associates. Our competent lawyers are skilled in workers’ compensation cases and can help you with your claim from start to finish. Whether you are hoping to reach a settlement with your employer, filing a third-party lawsuit in relation to your workers’ compensation claim or are in the midst of the appeal process, we can help you achieve the optimal end result to help you and your family in your time of need.