workers comp. Image by Janno Nivergall from Pixabay

Daniel Borisov writes stories about various aspects of the legal profession, especially as it relates to the needs of the public.

Workers’ compensation is designed to ensure that employees can access financial recompense if they’re injured while carrying out their duties. Regardless of who was at fault, workers’ compensation should ensure that workers don’t suffer financial loss because they have been injured.

If an employee needs to take time off work to recover, for example, workers’ comp should replace some of their income. In addition to this, workers’ comp benefits can also include the cost of medical treatment, dependency benefits, and/or vocational rehabilitation benefits.

Workers’ Comp Claim. Image by Janno Nivergall from Pixabay
Workers comp. Image by Janno Nivergall from Pixabay

Why Has a Claim Been Denied?

Many people assume that it’s easy to obtain workers’ comp, until they try to make a claim themselves. Unfortunately, the claims process is complicated and even the slightest error on the submission could result in the claim being denied.

If a claim is rejected, the applicants should be told why. However, it isn’t always easy to translate legal jargon into common sense. What’s more – the worker may disagree with the reasons given for rejecting the claim.

Depending on the situation, a claim denial could mean that a worker will not receive any workers’ compensation at all, or it may mean that the benefits received are reduced or time-limited. The person may be awarded temporary partial disability (TPD) but believe they should be entitled to dependency benefits too, for example. Alternatively, the applicants may believe their injuries justify permanent partial disability (PPD) benefits, but they are only receiving TPD benefits.

With so many elements of a claim to consider, there are endless reasons why a worker may not have got the result they were anticipating. To understand why a claim has been denied and to find out what the options are, it may be beneficial to seek legal advice.

Can a Workers Comp Decision be Appealed?

Yes. If a claim is rejected, or if a Notice of Intention to Discontinue (NOID) Benefits is received, there is a right of appeal. The applicant can re-apply or request a conference to discuss the cessation of their benefits. Although it is possible to attempt to navigate the appeals process as an individual, it can be tricky to do so, particularly when still recovering from workplace injuries.

However, working with experienced personal injury lawyers, like  can increase the chances of making a successful appeal and they can handle a claim on behalf of the worker. This alleviates the pressure and enables the person to focus on dealing with their injuries, rather than worrying about their workers’ comp claim. In addition, being legally represented can increase the chances of achieving a successful outcome.

Don’t Settle for a Denial

When a workers’ comp claim has been rejected, or the applicant is told they’ll no longer be receiving payments, it is essential not to accept the decision without further investigation. It’s not unusual for workers’ comp claims to be wrongly denied, which is why it’s so important to find out exactly why a claim has been rejected.

By getting legal advice and appealing the decision, workers can ensure they get the compensation they are entitled to following a workplace accident or injury. Filing a personal injury lawsuit is one option if other avenues fail or if the insurance company is playing hardball and making life too difficult.

An incident reported in Forbes shows some of the games insurance companies play, to avoid paying in full. They hope injured parties will give in when they make it too hard to recover the full amount. This is when lawyers such as the team at come into their own because they do not allow the insurance company to get away with playing those kinds of games.