Denied Claims

Denied Workers’ Compensation Claims

Legal Assistance in Farmington Hills, Michigan

Workers’ compensation is a great program that allows injured workers to recover from a workplace accident without worrying about their finances. But, of course, the benefits are only useful if you can get them. Like in most any claim, insurance companies responding to workers’ comp claims will be happy to deny yours if they can.

Adler Firm, PLLC in Farmington Hills can help you if your workers’ compensation claim has been denied for any reason. There could be an opportunity to challenge the denial through an appeal or a lawsuit, depending on the details surrounding your situation. It is our goal to help you find the most efficient path to recovery.

Call us at (888) 966-9524 for more information! We speak Spanish and English fluently.

Why Are Workers’ Comp Claims Denied?

A workers’ compensation claim can be denied for a myriad of reasons. Not all of those reasons will be valid, though. Employers and insurance companies will sometimes deny a claim just to try to get the claimant to give up, but not for any legally sound reason. If we’re working on your case, then we can look for ways to challenge the denial, regardless of what reason was presented for it.

Workers’ compensation claims are sometimes denied because of:

  • Incomplete or incorrect paperwork submitted
  • Claim filed after a statute of limitations has expired
  • Injury was preexisting or not covered by workers’ compensation
  • Injury was caused due to the claimant’s intentional neglect

Our investigation into your accident can help determine if the reason for denial is legitimate or not. Depending on what we find will decide what we have to do next. In any case, you can trust that we will be working towards your best interests all the while.

What Happens to Medical Bills When Workers’ Comp is Denied?

Most workers rely on worker’s compensation for its 100% medical bill coverage. Otherwise, they would be stuck with huge medical bills after an accident. But what happens to those medical bills if your claim is denied?

The timing of your claim denial is important in relation to your medical bills. In some situations, an insurance company could be required to pay for any medical bills you incurred between your accident and the denial. Or the insurer will be required to pay for any medical bills up to a cap, even if the denial happened before that cap was reached. The situation can vary quite a bit from one case to another, so it is useful to speak with one of our workers’ comp attorneys as soon as possible about your case.

How to Appeal a Workers’ Comp Denial

A workers’ compensation denial can be appealed if your attorney believes there is no legally valid reason for its denial. However, challenging a workers’ comp denial usually starts with sending a response letter to the insurer to ask for more information about why it was denied and/or to instruct them to reverse the denial at the risk of legal action. With an experienced workers’ comp attorney working on your case, there is a chance that this letter will be enough to convince the insurer to approve your claim.

Beyond a response letter, we can help you appeal by:

  • Creating an appeal letter
  • Accompanying your appeal with evidence of wrongdoing or incorrect procedures
  • Sending the appeal letter to the Michigan Department of Labor
  • Assisting with responses and inquiries

Can You Sue Your Employer for Denying Workers’ Comp?

Not every appeal is going to succeed, even when it is created and filed correctly. At that point, you will have two options: abandon your claim to workers’ comp or file a lawsuit.

Litigating a case is rarely simple, so it is often seen as a last legal resort. Our Farmington Hills attorneys would be happy to discuss with you all of your options to pursue compensation after your workers’ compensation appeal was denied.

We Answer All Your Questions – Call Now

You are bound to have plenty of questions after your workers’ compensation claim is denied. Get them all answered by our professional team. We help workers from all industries in Farmington Hills, so you can lean on us no matter what.

Get a consultation scheduled today. Dial (888) 966-9524.

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