After a workplace accident, you know that your employer has certain types of insurance coverage that may provide you with various types of support you may need during your recovery. A workers’ compensation claim allows you to seek financial restitution and other types of help you may need to get better and eventually return to work. Unfortunately, these types of claims may occasionally come back denied.
Learning that your workers’ comp claim came back denied can be frustrating, but it is not the end of the road for you. You may continue to pursue your claim by following the steps of the appeals process. Although it is still a setback, a denied claim does not mean that you will not be able to secure the financial recovery you need.
The next steps after a denied claim
If your initial claim is not successful, you will receive notice from the insurance company. This letter should specify the reason for the denial, and this will help you understand the next steps you will need to take to appeal the denied claim. Common reasons for insurance companies to refuse a claim include:
- It is not clear your injury is related to your work.
- Your injury is not compensable for various reasons.
- You did not include enough medical documentation in your initial claim.
- Your employer is disputing your claim.
- You did not file your claim within the required window of time.
The right approach for appealing a denied claim will depend on why your claim came back denied. You may need to gather additional documentation or include additional medical records that validate the nature of your injuries. You may find it effective to first discuss the situation with your employer or the insurance company to ensure that the denial was not the result of a processing error or clerical mistake.
What benefits are available to you?
The benefits available to you after a work accident depend on your injuries, your accident-related losses and other factors. Before you file your claim, you may benefit from an understanding of how to maximize the types of support available to you, as well as what to do if your initial claim was not successful. Injured workers in Missouri have rights, including the right to tenaciously pursue specific benefits after suffering from a work-related illness or injury.
