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What you need to know: Appealing a workers' compensation denial

You’ve been hurt on the job. Your injuries are preventing you from living the life you once did. You worry that there will always be pain. What if you can’t work again? Or, what if you can work, but not in your chosen field? With all these worries and questions already in your mind, learning that your workers’ compensation claim was denied can feel like such a crushing blow.

If your claim was recently denied, though, now is not the time to give up. Rather, now is the time to further investigate appealing the denial.

How to appeal a denial in Massachusetts

In Massachusetts, the Department of Industrial Accidents is the office that oversees workers’ compensation in the state. Just like how you filled out specific paperwork to initially file your claim, you will once again be filling out more paperwork to appeal the denial.

If you have already received a notification of denial form, you will need to fill out an Employee’s Claim – Form 110 and send this back to the department and the insurer. It is very important to fill out everything on this form accurately and completely, and you will want to keep copies for yourself too.

With this form, you must also attach all the evidence that supports your claim. This should include:

  • Medical bills
  • Medical reports from doctors
  • Any other medical evidence that further documents your injuries or illness

Getting ready to show the proof

Proving your injuries or illness after a denial is more than just filling out a form though and attaching medical documents. Rather, you want to be able to prove not only your injuries, but that the insurance company made a mistake by denying your claim in the first place. With so much riding on getting this claim approved, this is why many do turn to an attorney when appealing a denial.

A big part of the appealing process is often getting the documentation to really prove your injuries. This can involve going back to the doctors and medical staff you originally saw to get more information and documentation that backs up your claim.

The good news is that it is very possible to appeal a denial and end up receiving compensation. So often people think the initial denial is the end of the road and give up hope. Rather, it’s important to keep in mind that insurance companies tend to have their bottom line in mind when making decisions and often do make mistakes. Now is not the time to give up. Rather, it’s the time to review the documentation you currently have and see where you can more concretely explain and justify your reasoning for needing and deserving compensation.

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