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Why Was My Evansville Workers’ Compensation Claim Denied?

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Employers try to pay as little to workers’ compensation claims as possible because doing so raises their insurance rates and increases their liability. For this reason, they look for discrepancies in the claim or try to argue an injury occurred or worsened at home rather than at work.

Besides these common tricks, there are many reasons why your workers’ compensation claim may have been denied, but the good news is you may not have to settle for this initial denial. Read your denial letter carefully to see if you or an Evansville workers’ compensation lawyer can strengthen your claim and reapply.

Report Your Injury On Time

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Indiana employers are bound by state laws to report  workplace accidents  within 30 days of the accident. However, the longer you wait to tell your employer about your injury, the less credible the account may be. For example, the insurance company may deny your claim because you waited 10 days to see your doctor and receive a diagnosis — how can they be sure you didn’t hurt yourself at home between the time of the accident and when you were diagnosed?

File a Mistake-Free Accident Report

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When you report a workplace accident injury to your employer, make sure to include the following details in your report, whether verbal or written:

  • Your name and contact information
  • When your injury occurred
  • Where the accident took place
  • How you injured yourself
  • What symptoms you are currently experiencing

A thorough report up front will make it harder for the insurance company to find discrepancies or ambiguities between a doctor’s diagnosis and your claim.

While you should be thorough in your report, don’t speculate on the details of your accident if you aren’t sure about them. For instance, if you don’t know why you slipped and fell off a ladder, don’t suggest a cause in the report. Likewise, avoid self-diagnosing your symptoms until you meet with a doctor and have a written medical diagnosis of your injury.

Even if you take all these precautions, your employer might still dispute your claim. The letter of dispute will explain what extra evidence or procedures you need to provide, but that varies from case to case. If you are confused about why your claim is being disputed or what materials you must gather to continue filing, consider calling an Evansville workers’ compensation lawyer to help.

Appeal Your Claim Denial

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You have the right to appeal your workers’ compensation claim if you believe your employer or their insurance company wrongly denied it. The denial letter will have details about the appeal process, as well as important deadlines, so read and make note of these before beginning the process.

You can also appeal claims you believe do not fully compensate you for the extent of your injuries. The process is the same for these appeals as well.

A few denied claims are the result of misfiled paperwork or miscommunication between you, your employer, and the insurance company. In these rare cases, a simple phone call could clear up a discrepancy and get your claim approved. Because this doesn’t happen often, you will probably have to attend a hearing for your claim.

In Indiana, the Workers’ Compensation Board handles all appeals for denied benefits. You must file an adjustment of claim application with the Board within two years of your injury and then present your case at a hearing. At the hearing, you will be asked to present medical, personal, and other types of evidence to prove your injury was caused by your job, resulted in lost wages or time off work, and has incurred medical expenses.

Help From an Evansville Workers’ Comp Attorney

You may feel overwhelmed and frustrated by being denied workers’ compensation and missing days of work due to your workplace injury. If you’re looking toward the appeal process with dread, consider calling a local lawyer to help ease the burden of this task. The qualified attorneys at Hensley Legal Group can help file your appeal, strengthen your claim with relevant evidence, and meet deadlines so you can focus on getting well. Contact us today for a free consultation of your claim.