Workers compensation insurance protects you from the financial problems that come with job-related injury. If you are injured while working and workers compensation does not pay, it does not necessarily mean that the process is over. You can still implement a plan of action to get the money owed to you.
Appealing the Denial
When you file a workers compensation claim with your employer, it will then be sent to the insurance company. The insurance company then has a chance to review the facts in the claim before making a decision on whether it will pay. If the insurance company denies the claim, you will get an explanation in the mail. At that point, you can appeal the claim. To do so, you must complete the process within the deadlines presented on your explanation of denial.
Workers Compensation Judge
If you decide to appeal the claim denial, you will have the opportunity to appear before a workers compensation judge. If you let the process get this far, you must have compelling evidence to present to the judge. You will also want to hire an attorney to represent you in court. Legal counsel can help you establish a defense against the denial, and increase your chances of receiving your financial benefits.
Suing the Employer
Another option that you may have is to sue the employer. You can sue your employer for two different reasons in this situation -- either you can prove that it was employer negligence that lead to your injury or if your employer does not have workers compensation insurance or a lack of coverage. For example, if your injuries total more than the amount of the coverage, you could sue.
Minimizing the Chance of Denial
Getting a workers compensation claim denial overturned can be difficult. To avoid having your claim denied during the appeals process, you need to complete it in a timely manner. As soon as you receive your letter of denial from the insurance company, you must respond to it immediately. You also need to present all of the facts in the case clearly and accurately. If any discrepancy exists in the facts, your case could be denied again.
