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My Workers’ Comp Claim Was Denied: What can I do?

February 1, 2020

Thousands of people each year get hurt while on the job. When you get hurt at work, generally, your employer should be responsible for paying for your medical treatment and for providing you with a portion of your wages while you are not able

to work. Most companies are required to have workers’ compensation insurance. Unfortunately, some workers’ comp claims are denied or the benefits are withdrawn too early. If you were hurt at work and your workers’ comp claim was denied, there are some legal actions you can take. An experienced workers’ comp attorney will assist you with your claim and help you get the benefits you deserve.


How the Workers’ Compensation Claim Process Works

 

As soon as you suffer an injury at work, you must report it to your company. Follow your company’s procedures and report it to your supervisor or the HR department. Make note of the exact location, date, and time of the incident as well as the names of any witnesses. The company should file a report with the State of Wisconsin Department of Workforce Development. Make sure that you file a claim in a timely manner because if you do not, your claim will likely be denied.

 

If you file a claim that your company disputes, you may need some assistance to resolve the situation. Companies often try to avoid filing a report because they do not want to provide benefits. You may be entitled to medical care, temporary or permanent disability, vocational rehabilitation, and other expenses associated with the injury. You should receive a portion of your regular pay if you are off work for more than a week due to the injury. You should receive a letter that explains the benefits or provides you with a reason that they denied your claim.

 

Resolving Workers’ Comp Claim Issues

 

If your claim was denied, you the letter you receive should provide you with a reason. In some cases, the injury is disputed or sometimes you did not submit the required information. If the claim is denied, you have a chance to file a dispute.

Disputes are handled through a formal process if you have an attorney or an informal process if you do not have legal representation. The dispute is handled by a member of the Alternative Dispute Resolution Unit (ADR). The formal process includes a hearing with an Administrative Law Judge (ALJ).

 

You must complete an application and provide medical information that supports your dispute. It can be extremely beneficial to get help from a skilled attorney. Your lawyer understands the process and will help you gather the necessary documentation to prove your case. Once the ALJ reviews the matter, he or she will provide a formal order. If you still feel that the resolution is not correct, you can appeal the matter to the Labor and Industry Review Commission (LIRC). If you disagree with that decision, you can further appeal to the circuit court.

 

If you were hurt while you were at work or on the clock, you are likely entitled to some workers’ compensation benefits. Contact our legal team at Moen Sheehan Meyer, Ltd. to discuss the details of your injury today.

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