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Workers Comp Denied: Here’s What to Do

If you’ve been injured at work, you’re likely facing the stress of mounting medical bills without income. Workers comp is meant to provide you with financial assistance until you’re able to work again. You might think that it’s a straightforward process— you get hurt on the job, you’re entitled to compensation— but many Indiana workers find their claims are initially denied.

What happens next? Can workers’ comp deny a claim? Where do you turn to ensure that you get the compensation you’re owed? 

In this article, we’ll walk you through the reasons your claim might be denied, the steps you should take if your worker’s comp claim is denied, and what you can expect from the appeal process. 

Why Was the Workers’ Comp Claim Denied?

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Maybe you’re wondering, can workers comp deny a claim? In one word, yes.

There are several reasons why the Worker’s Compensation Board might reject your claim.  Filing a claim is a complex process, and there can be missteps at any point along the way. 

Here are a few of the most common reasons workers’ comp claim denied:

  • Employer disagreement— if your employer is unconvinced that the injury occurred on the job, if they believe you were under the influence of alcohol or illegal drugs, or if you haven’t provided ample proof of injury, they might refuse to submit the paperwork. 
  • Failure to File— if you don’t file the claim within 30 days of the incident, it could be denied. Additionally, if you don’t file all the required paperwork, your claim could be denied.
  • Unauthorized Medical Professional— In the state of Indiana, the employer’s preferred medical professional is authorized to determine whether your injury qualifies for workers’ comp. You won’t necessarily be able to visit your own doctor— you’ll likely have to see a doctor approved by your employer’s insurer. 
  • Lack of Documentation— If you haven’t submitted sufficient medical documentation that confirms the cause of your injury, your claim will likely be denied.
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In many of these cases, it’s simple to fix the issues that led to the denial. An experienced workers’ compensation attorney can help remove any roadblocks between you and the compensation you deserve. 

Your Workers’ Comp Claim Denied, Now What?

Time is of the essence when you receive a workers’ comp denial. As soon as your claim is denied, the next step is to begin the informal dispute process. This is initiated when you turn in a Request for Assistance form. This notifies the state board that you want in inquiry into the claim. 

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While you are legally permitted to act on your own behalf, retaining the services of a workers’ compensation attorney at this point will help you ensure that all the steps are completed properly.

Escalate Your Appeal

In many cases, the issue is resolved through the informal dispute process. However, if you still don’t have satisfaction, the claim can be escalated to the next step: a hearing with a Single Hearing Member of the Worker’s Compensation Board. 

Again, timing is key— you can only file the Application for Adjust of Claim within two years of the date the injury occurred. If you’ve dragged your feet at any point in the process, you could find yourself left without further options. 

When the application’s received by the board and assigned a cause number, a Single Hearing Member is assigned to the case, and they’ll hear both sides of the issue. The corporation is legally required to be represented by an attorney at this point in the process. If you haven’t retained a lawyer yet, now’s the time to get a legal representative who can speak on your behalf. 

If both parties are satisfied with the Single Hearing Member’s decision, the claim is complete. If either party is unhappy with the outcome, an appeal can be filed within 30 days. At this point, your case is reviewed by the entire Worker’s Compensation Board.

If either party is dissatisfied after their ruling, any additional appeal is made to the Indiana Court of Appeals and then, finally, to the state Supreme Court. This is very rare— the majority of worker’s comp disputes don’t progress that far. An attorney can provide advice about whether your case is worth pursuing this far. 

Workers’ Comp Claim Denied? Talk to Crossen Law Firm

When you’re out of commission, the last thing you want to deal with is the headache of a workers’ comp claim. Crossen Law Firm is here to help.

For decades, our team of experienced workers’ comp attorneys have helped Hoosiers navigate the challenges of workers’ comp, from start to finish. Our free consultation will provide you with the guidance you need to successfully appeal your denial. 

Contact Crossen Law Firm to get the support you need today. Call 317-401-8626 for a free consultation or contact us online.