What to Do with Denied Workers’ Compensation Claims

You have certain rights if you incur an on-the-job injury in the state of Arizona. If you recently filed a Phoenix workers’ compensation claim and received a denial, you may be feeling disappointed or confused. It can be disheartening to hear that you may not qualify for benefits, but there are still other options available. Workers’ compensation claims are often denied on a technicality or for other reasons that are easily rectifiable. If you recently received a denial letter from your employer’s workers’ compensation insurance company, take the following steps:

1.) Know the Most Common Reasons for Claim Denials

There are a few common reasons why injured workers face claim denials. The first is that a worker did not report an injury to an employer, either on time or at all. Arizona law requires that an injured worker immediately report an injury to his or her employer, and that the employer inform the workers’ compensation insurance company just as quickly.

Another common reason for denial is that an employer disputes the claim. For example, an employer may argue that an injury was not work related or that your injury was the result of an “accident.” (i.e., that it was your fault). If this applies to your case, getting a claim approved might be a matter of gathering more evidence, like eyewitness accounts or a note from your health care provider.

Employers will sometimes look for any reason to dispute a claim. When they make workers’ compensation claims, their insurance rates go up and this costs the company money. It might not be fair to you, but it’s a common reason for a denied claim. This is one reason why it’s essential to retain the services of a workers’ compensation law firm.

2.) Ask for an Appeal

Your claim denial letter will probably detail how you can file for a workers’ compensation appeal. Read your letter carefully and make note of any filing deadlines. Next, contact your employer or their insurance company to discuss the reason for the claim denial. If it’s a simple matter of misplaced paperwork or a filing mishap, you should be able to rectify it fairly easily. If the claim denial is for another reason, you will have to proceed with filing an appeal.

3.) Hire a Workers’ Compensation Attorney

Whatever you do, don’t give up or lose hope just because you receive an initial claim denial. Instead, talk to a Phoenix workers’ compensation attorney as soon as possible. Appeal deadlines are often strict, and working with a lawyer from Cruz & Associates can help you maximize your chances of receiving workers’ compensation benefits.

Claim appeals can be legally complex procedures, so it’s essential to have an advocate with an in-depth understanding of workers’ compensation and insurance law.

Cruz & Associates brings 25 years of experience to your workers’ compensation appeal. If you recently received a claim denial letter, contact us to schedule a free initial consultation with our firm. We’re committed to helping you understand your rights and responsibilities under the law.