How Can You Overturn A Workers’ Comp Denial?

It is not uncommon for legitimate claims for workers' comp benefits to be denied. If you were one of those denied claims, you have the right to request an appeal. To overturn the decision of the insurance company, you might have to take a number of steps, including collecting witness statements. To help with your appeal, here are some of the most common reasons for denial and possible methods of overturning the decision. 

You Failed to Sign a Medical Authorization

One of the first things the insurance company probably asked you to do was sign a medical authorization so it could obtain copies of your medical records. If you refused to sign the authorization, the company could argue that it could not determine the extent of your injuries and therefore, you were not entitled to benefits. 

You are not legally required to sign an authorization. When you do, the insurance company can use it to request more than just the records that pertain to your injury. Insurance companies routinely use medical records to find past incidents that could be blamed for injuries. 

If you were concerned about the insurance company doing this to you, you can still provide them with the records they need and keep your past medical records private. Instead of signing the authorization, you can obtain copies of the relevant records yourself and provide them to the insurance company. 

Your Story Was Inconsistent

Every word of your initial statement to your employer regarding your accident will be checked against your medical records. If there are any inconsistencies, the insurance company could use them to challenge the validity of your claim and deny you benefits. 

Depending on the type of inconsistencies, you might be able to rely on witness statements from co-workers to help support your case. If there is videotaped evidence of the accident, you can also ask that it is considered. 

If you gave your initial statement to the employer shortly after the accident, you could argue that you were not in a mental and emotional state to remember all of the details of the accident. When discussing your case in the future, be sure to try as be as consistent as possible to avoid further challenging of your claim.

Consult with a workers' comp attorney to help you handle an appeal of a denied claim. The attorney can evaluate your claim and the denial and determine the best way to have the decision overturned.


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