What should you do next after a denied workers' comp claim?

If you endured injuries in a workplace accident, you know how this type of incident can result in physical and financial suffering. Your work accident can leave you with both painful injuries and medical bills that you cannot manage on your own. This is why workers' compensation benefits are important during your time of recovery.

It can be devastating to learn that your claim for workers' compensation benefits came back denied. How will you pay your medical bills, especially if you can't work? You may feel devastated over the denial, but this is not the end of the road for you. Insurance companies do not have your best interests in mind, but you can continue your fight through other steps. You don't have to give up on getting the support you need.

Common reasons for a denial

When you get a letter from the insurance company explaining that it was not approving your claim for benefits, it probably contains an explanation for why the company denied it. Even with sufficient medical documentation and a valid work-related injury or illness, you may still get a denial the first time. Some of the most common reasons for claim denials include the following: 

  • There is not enough evidence to prove the injuries relate to the claimant's work somehow.
  • The injury may not be compensable for various reasons.
  • It is not clear that the injury required medical care or left you unable to work.
  • You did not report the injury in time, or you did not file your paperwork in the right amount of time.
  • Your employer is disputing the claim.

It can be disappointing to learn that your claim for benefits was not successful, but there are still options available to you. Once you understand why the insurance company denied your claim, you can then move forward with an appeal. You may be able to present new evidence or include additional documentation that will help validate your claim.

Don't give up quickly

Getting your rightful workers' compensation benefits after a work accident or diagnosis of a work-related illness is important. You have the right to seek benefits, and you have the right to keep fighting if things do not go as planned the first time. If you need to appeal or you want to know how to increase your chance of success the first time, you may want to start by reaching out to a Texas attorney for an assessment of your case.

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