What happens when your workers' compensation claim is denied?


It could happen to anyone. You're at work. You're doing your job, like you do every day. Nothing is out of the ordinary. But suddenly, something happens and you're injured.

You contact medical help as soon as possible. The procedures go well. But then you get the bill in the mail. It's ridiculously high. There's no way you could afford something like that.

But it's going to be okay because you have insurance. You're covered by workers' compensation. 

You file a claim, thinking everything's okay. But it isn't. Because now the insurance company says that you're not eligible. Your benefits have been declined. That enormous bill you got from the doctor's is sitting there, burning a hole in your kitchen counter.

After suffering a painful work-related injury, the worst thing that can happen is for your benefits to be denied. If your workers’ compensation claim has been disputed, you may be eligible for a claim.

In the case of a denied claim, the best step is to contact a workers’ compensation attorney who can help you receive the compensation you deserve.

Common reasons for claim denial

Sometimes, insurance companies can deny your health benefits for a slew of ridiculous reasons. When this happens, they are looking out for their best interest, not yours. Many companies will den your claim for a number of reasons, including:
  • Claims were not reported or filed on time
  • Employer disputes the claim
  • Conditions of work injury are not covered by insurance company
What to do when your claim is denied

You will usually receive a letter stating that your claim was denied. Usually, the letter will also detail how you can appeal the claim.

After you receive this letter, be sure to:
  • Take notes of reason for denial and any deadlines to appeal the claim
  • Contact your workers’ compensation insurance carrier to discuss the letter
  • Seek legal advice

Talk to a workers’ compensation attorney

If your employer and insurance carrier still refuse to handle the claim, you must talk to a workers’ compensation attorney. Depending on your work injury, you may be eligible for compensation for your pain and suffering. Don’t simply accept your claim denial. Fight for your rights.

A workers’ compensation attorney will be able to determine whether an appeal for your claim denial is the best course of action. Attorneys will be able to handle deadlines and walk you through the process so that you do not have to suffer by yourself.