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Knowing why your claim for benefits may have resulted in a denial

On Behalf of | Mar 27, 2019 | Firm News

Suffering a major injury at work can be a stressful and intimidating experience, and the aftermath of your incident could leave you facing a lengthy period of recovery. With the impending loss of income, you may feel that you will struggle to afford the extensive medical expenses you accumulated in the process.

Following your accident, you might have sought relief through the workers’ compensation insurance system. You might be relying on this relief to help you make it through these troubled times, but what happens if your claim for benefits results in a denial?

Why claims may result in a denial

There are varieties of scenarios in which you may receive a denial when applying for benefits and knowing what caused the denial could prove essential to filing an appeal. Some of the most common causes of denied claims often include the following:

  • Timing of report: There are rules in place that depict how long you can wait before reporting the incident and failure to notify the necessary parties within this time frame could prove detrimental.
  • Circumstances of accident: There are certain circumstances in which your employer may dispute your claim for benefits. Should it appear that your accident took place outside of work or came as the result of unapproved behavior, your claim may result in denial.
  • Type of injury: The type of injury you suffer may also have an impact on your eligibility for compensation, as each state has its own rules pertaining to which injuries are compensable.
  • Lack of medical care: Following your accident, it is advisable to seek medical attention as soon as possible. If you are unable to provide proof of medical care, your eligibility for relief may diminish.
  • Was the accident work-related: You may also bear the burden of proving that the incident took place while on the job and failing to do so could cause your claim to be unsuccessful.

Regardless of why it happens, it would be in your best interests to seek guidance from someone who is knowledgeable in Massachusetts state workers’ compensation laws prior to filing an appeal.

Filing an appeal

Receiving a denial for a workers’ compensation claim can be a harrowing process. With the gravity the outcome of your appeal could have on your situation, you will likely want to take every possible measure to ensure you obtain the most favorable outcome possible. You could choose to obtain guidance from someone with experience in such intricate matters and doing so may help you become better prepared to pursue the full amount of benefits achievable through every applicable source.