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What if my workers’ compensation claim was rejected?

On Behalf of | Feb 8, 2023 | Workers' Compensation |

Workers’ compensation is comparable to a security blanket for New Hampshire workers. Knowing that they are protected if they are injured or suffer a work-related condition that leaves them unable to work gives peace of mind as it can cover their medical expenses and wages as they recover.

However, an approval for a workers’ compensation claim is not guaranteed. It is not uncommon for claims to be rejected with the injured worker and their family wondering what options are available. Fortunately, there are ways to appeal a denied claim.

Those who believe it is a formality could not be more wrong. Many people whose initial claims were rejected eventually get workers’ compensation. A key is having comprehensive advice with how to proceed.

Rejected workers’ compensation claims can be appealed

A denied claim does not mean the case is over. Often, it is a simple matter of the workers’ compensation insurer not having all the information it needs to approve the claim. There might be missing medical reports or an unsigned form.

It could have been denied because the injury is not covered by insurance. The worker is obligated to seek medical treatment. If they did not, it could lead to a denial. Employers may claim that the injury did not come about due to a work accident or incident. There might be a lack of witnesses.

Those who want to appeal can seek a hearing. From the time the claim is denied, the injured person has 18 months to seek a hearing to have the denial overturned. For a department-level hearing, the request needs to be in writing with the reasons for which the request is being made. If the hearing is about a worker’s eligibility, there needs to be the medical report giving work release or a medical report stating the worker is disabled.

In some cases, there are allegations that the worker is not complying with the vocational rehabilitation program. This hearing needs to cite the report about the lack of cooperation or an explanation as to why there is a problem.

The Compensation Appeals Board is a panel consisting of three people—a lawyer, a labor representative and a representative of the insurer or management. This appeal will be held around six months from when the request is made. This is an entirely new hearing where additional evidence can be provided to prove the viability of the case.

Experienced assistance may be vital with rejected workers’ compensation cases

People who are in this complicated situation should be fully aware of the need for guidance. Contacting professionals who value honesty and fairness while being tough and reasonable can make a major difference in the outcome of the case. Injured workers thinking they will not get their workers’ compensation benefits can have their fears assuaged with information that helps them understand what can be done.

It is wise to call for help from people who are entrenched in the community, have decades of experience and give personalized assistance with getting the workers’ compensation coverage they need. This can be crucial for making a recovery, getting training to get back on the job or find a different type of job, receiving wage coverage and more.

Since New Hampshire residents pride themselves on vigilance and hard work, it is not much to ask that their legal representatives live by the same code. This is fundamental when fighting a denied workers’ compensation claim. Seeking help from the outset is imperative with a case.