What You Can Do If Your Workers’ Compensation Claim Was Denied

Updated on March 31, 2021

Most states require employers to carry workers’ compensation insurance to cover employees in the event of a work-related injury. There are instances in which your claim for workers’ comp is denied; however, there are options available, including appealing to the state board of workers’ compensation.

Why was the claim denied?


Insurance companies are notorious for finding reasons to deny workers’ compensation claims. There are several reasons why your claim may be denied. You must report your work-related injury to your employer in writing immediately so that you can file a claim for benefits. If you file outside of the statute of limitations, you’ll likely be denied. Disputes often arise about whether an injury is truly work-related. You’ll need firm evidence of negligence, an unsafe work environment, witness accounts, and medical treatment records to prove your injuries result from a workplace accident.

It could be that your state excludes your disability, illness, or work injury when claiming cumulative trauma or psychological conditions. Insurers will almost always deny claims that are filed after an injured employee leaves the job. This is tricky, especially if you were injured on the job and reported the incident in the final days leading up to leaving the job.

What to do when your claim is denied.


Whether your first claim is denied or not, you are entitled to workers’ compensation benefits. You should receive a letter detailing why your claim is denied. Sometimes it’s a matter of incorrect paperwork that you can clear up with a claims adjuster. You should find information in the denial letter about how you can appeal. Each state has a different appeals process, but it usually starts with a hearing before an administrative law judge where you can submit medical and other supporting evidence for your claim.

Prescription medications play a big role in your overall medical expenses. Even with insurance coverage, prices can be steep. USA Rx gives you the best discounts on the market for prescription medications. Using their free mobile app, you can find medications discount offers at local pharmacies or online. Anyone who wants to reduce their out-of-pocket costs for prescription drugs can take advantage of the discount program. Search for your medication on the app, and you’ll receive discounts and coupons that you can present to your pharmacist so that you can pay the lowest price possible.

Get legal advice.


When your denial letter isn’t clear, it may be best to seek legal advice regarding your workers’ compensation claim. Legal advice can help you decide whether an appeal is the best option for your circumstances. There are strict and short timelines for filing a claim appeal. A skilled workers’ comp attorney with years of experience can help you every step of the way to get you the benefits and financial compensation you deserve. WINInjury Network has years of experience providing legal assistance to those suffering from personal injury and workplace injury.

Their personal injury lawyers and workers’ compensation claim specialists are experts in accident-related injuries. They’ll make sure you can financially access the medical care you need if your employer or insurance company denies your benefits. When you need an experienced work injury attorney in Chicago, the law firm specializes in accident-related injuries, personal injury cases, and workers’ compensation benefits. Their legal team will help you get the fair compensation you deserve promptly.

It’s your right as an employee to be protected by workers’ compensation benefits when you sustain a work-related injury or work-related illness. The sooner you file a claim, the sooner you can start receiving your maximum benefits. In the event your claim is denied, don’t take no for an answer.

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