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Denied Workers Compensation Claim Attorney

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Denied Workers Compensation Claim

Following a workplace illness or injury, Delaware employees should be entitled to adequate workers’ compensation benefits under state law, since every company that has at least one employee must purchase workers’ comp insurance. However, there are a number of workers’ compensation claims that do get denied by employers on a regular basis. Denial of a claim results in decreased liability for the insurance company and lower insurance premiums for your employer. For this reason, adjusters and employers will often search for any possible reason to deny your claim. If you filed a claim for benefits and have received a denial, you should immediately contact an experienced workers’ compensation lawyer who is familiar with the system in Delaware. Attorney Ryan Zavodnick assists employees in Delaware with a wide variety of workers’ comp matters, including claim denials. Do not hesitate to call our office today at 215-875-7030 to discuss your case.

Potential reasons for a denial

There are several reasons why an employer may deny your workers’ comp claim. The following are some examples of common denial reasons:

  • You did not report your injury or file your claim for benefits in a timely manner.
  • No one witnessed your injury to support your claim.
  • A discrepancy exists between your report of the incident and the information in your initial medical evaluation.
  • Your initial medical evaluation revealed you were under the influence of illegal substances.
  • You refused to authorize the workers’ compensation insurance company to access your medical records.
  • You refused to give a recorded statement to the insurance company.
  • Your claim was not filed until after you were terminated from your position.
  • Your employer believes that your injury or illness arose from factors outside the scope of your employment.
  • Your employer believes that your injury was preexisting.

These are only some examples of reasons employers commonly give when they deny a workers’ compensation claim. When you receive you claim denial letter, you should always review the letter with an experienced attorney as soon as possible. A work comp attorney can help you gather evidence if your employer disputes your injury

What to do after a denial

The first step following a workers’ compensation denial is often to contact your employer or the insurance company to discuss the reasons for your denial. If you simply made a mistake on the claim paperwork or your employer made a clerical error, it may be possible to clear up the issue so that your claim is reconsidered. Having an experienced workmans’ comp attorney place this phone call can often be extremely helpful in straightening out any potential issues. If your employer will not reconsider its denial, you have two years during which to file a petition for a hearing with the Delaware Office of Workers’ Compensation. The next steps in the appeals process can include the following:

  • Completing a detailed pretrial memorandum
  • You are assigned a hearing date
  • You appear at a hearing before either the Industrial Accident Board or a Hearings Officer
  • Your employer has a specified time limit during which to request mediation to resolve any issues that may still exist
  • If the Industrial Review Board denies your appeal, you have 30 days to appeal its decision to the Delaware Superior Court
  • You have a proceeding in court following all necessary rules and procedures.

As you can see, the appeals process can become quite complicated and lengthy, and you should always have the guidance and assistance of an experienced attorney throughout this process.

Contact an experienced workmans’ comp lawyer for assistance today

If you have lost income and incurred medical costs due to a workplace injury, a workmans’ comp denial can seem devastating at first. You should always know that you do have options and there is still a chance you will receive benefits. You can greatly increase those chances by consulting with an experienced workers’ compensation lawyer as soon as possible. Not only can a lawyer handle your appeal while you focus on your recovery, but a lawyer will also know the best way to approach your appeal of a denial. If your case does go to a hearing, an attorney can zealously represent your interests while following all necessary procedures.
Ryan Zavodnick is an experienced and skilled Delaware workers’ comp attorney assisting injured employees with denials, so please call our office at (302) 364-6047 to discuss how we can help you today.