Next Steps After A Denied Workers’ Compensation Claim

Designed to provide financial relief to employees who are injured or become ill due to their job, Maryland workers’ comp claims are sometimes rejected. If you’ve received a denial, don’t lose hope, there may still be a way to access financial relief.

By understanding why the claim was denied, gathering additional evidence, and working with a knowledgeable Baltimore personal injury lawyer, you can appeal the decision and seek the benefits you deserve.

Why Workers’ Compensation Claims Are Denied

Before discussing the next steps, it’s important to be aware of why a workers’ compensation claim was denied. Common reasons include:

• Lack of evidence. Insufficient medical documentation or missing paperwork can result in a denial.
• Injury disputes. Your employer or the insurance company may argue that your injury did not happen at work or is not work-related.
• Missed deadlines. Claims require specific deadlines for reporting the injury and filing paperwork. Missing these deadlines can lead to a rejection.
• Pre-existing conditions. If the insurer believes your injury was caused by a pre-existing condition rather than a workplace accident, your claim may be denied.

When your claim is denied, you’ll receive a denial letter. Carefully review this letter. This will help you determine the best course of action for appealing the decision.

For example, if your claim was denied due to insufficient medical evidence, your next step may be to gather additional medical records or get a second opinion from a healthcare provider to strengthen your case.

After receiving a denial, know that you have the right to appeal the decision. In Maryland, workers must file a request for a hearing with the Workers’ Compensation Commission (WCC) to start the appeals process. The key here is to act quickly, as there are time limits for filing an appeal.

Once the request is filed, you will have the opportunity to present evidence at a hearing. This is where having an experienced attorney can be invaluable. They can help you build a strong case and represent you during the hearing. This includes obtaining detailed medical records, gathering witness statements to support your claim, and collecting any workplace communications about your injury.

Accessing Other Forms of Relief

As soon as you begin working with a Baltimore personal injury lawyer, they can identify the evidence that will be most effective and guide you through the process of collecting and submitting it. They may introduce you to other avenues for financial relief as well.

If your injury or illness leaves you unable to work, for instance, you may qualify for Social Security Disability Insurance (SSDI) or short-term disability benefits through your employer. Or you may be able to file a personal injury lawsuit if a third party, such as a contractor or equipment manufacturer, was responsible for your accident.

Were you under the impression you would receive workers’ compensation but instead received a claim denial? There are a range of ways to access monetary recovery, talk to the qualified legal team at Iamele & Iamele, LLP to learn more. Contact us to book your confidential appointment.