When Workers Comp Claims Are Denied
Unfortunately, as a construction accident lawyer New York workers trust can attest, not all workers’ compensation claims go as smoothly as they should. Even if the injuries you sustained clearly happened on the job and are severe, you may run into problems with your employer’s insurance provider or even the employer themselves.
However, when you receive a denial, you have the right to challenge the claims administrator’s decision. During this process of challenging the claim, it is in your best interest to seek the advice of a construction accident lawyer New York locals recommend.
A New York construction accident lawyer can not only help you decide if an appeal is the right way to go, but can also help you navigate the paperwork, gather evidence, and build a case that will win in court.
At Polsky, Shouldice & Rosen, our attorneys have been helping injured workers file claims, appeal denials, and negotiate settlements for more than 20 years. If you need the assistance of a skilled construction accident lawyer New York victims rely on, we are available to help.
Common Reasons for Claim Denials
Approved insurance claims cost everyone money. That is, they cost your employer and their insurance provider money in terms of higher insurance rates and lost profit, respectively. As such, it does not make good economic sense to accept every workers’ compensation claim without thorough analysis. Unfortunately, it does not always stop there.
A construction accident lawyer New York residents depend on knows that some employers or insurance claim adjusters will come up with any imaginable excuse for denying coverage. It may come down to a lack of trust (the employee or insurance adjuster does not believe that the injury occurred on the job), or the claim may be denied for more mundane reasons, such as an improperly filled out or signed claim. Here are some of the more common reasons why claims are denied:
- The injury was not reported immediately. In most states, workers have a limited number of days from the accident to notify their employer of the injury, according to the state’s workers compensation commission.
- Workers that come down with an occupational disease must notify their employer as soon as they are aware of the illness.
- The injured person was not treated by a medical professional immediately (or at all), which may lead a claims adjuster to believe that the injury was not serious.
- There were illegal drugs in the injured person’s blood work when they went into the emergency room for treatment.
- There were no witnesses present to the injury.
- The accident report does not match medical records. For example, the injured person claimed they fell down a flight of stairs but their injuries do not match up to that type of accidental fall.
- The claim was filed after the employee was fired or let go.
- The paperwork was not completed correctly.
If Your Claim Was Denied
While workplace fatalities have been on the decline in many states, serious injuries still occur in all too high numbers. A construction accident lawyer in New York knows that workers’ compensation is an essential aid in getting employees like you back on your feet.
If you are dealing with a denied claim, contact a skilled construction accident lawyer New York provides at Polsky, Shouldice & Rosen today at (516) 595-0106 for immediate help, as the deadline for making an appeal is usually very short.