Workers’ compensation is vital for employees injured on the job. However, insurance companies sometimes deny these claims. Understanding the common reasons for denial and what you can do about it can help you navigate the process effectively.
Common reasons for claim denials
One common reason for claim denial is insufficient medical evidence. Insurance companies need detailed medical records to validate the injury and its severity. Without proper documentation, they may question the legitimacy of the claim.
Missed deadlines
Filing deadlines are crucial in workers’ comp cases. If you miss the deadline to report the injury or submit the claim, the insurance company might deny it. In Wisconsin, you typically have 30 days to report the injury to your employer.
Disputed injury cause
Insurance companies might deny a claim if they believe the injury did not occur at work or is not work-related. This often happens when there is a lack of witnesses or conflicting reports about the incident. When appealing your claim, you may need to address any conflicting reports or seek additional witnesses along with other steps.
What you can do about a denied claim
Collect comprehensive medical records, including doctor’s notes, test results, and other relevant information. Report your injury immediately and adhere to all filing deadlines to prevent claim denial.
Submit a thorough, accurate report of the injury. Include witness statements and ensure consistency in your account.
Steps to take after a claim denial
Dealing with a denied workers’ comp claim can be tough, but knowing the common reasons and taking proactive steps can improve your chances of a successful appeal. When you have done all you can do and your claim gets denied, consult with an experienced Wisconsin Workers’ Compensation attorney immediately.