Facing a workers’ compensation claim denial

If you are injured at work, you face a challenging path to receiving benefits while getting healthy. After your injury, you followed the protocols, submitted the required documents, and filed for workers’ compensation claims. However, you received a letter denying your claim a few days later. Getting injured and missing out on work is already stressful; how much more would it be if you must fight for your compensation, too?

There are still things you can do if your claim was denied. Here are the steps you can follow to appeal for your workers’ compensation claim:

  • Step 1: Read the denial letter and understand the reason behind it. The letter should explain the exact reason for denying your claim. Your employer might argue that the injury was not work-related. They could also say that the injury was a pre-existing condition. The insurance company might also dispute that the injury is not severe enough to seek medical care. Understanding the reason behind it would help you prepare for your appeal.
  • Step 2: File an appeal to the workers’ compensation commission in North Carolina, which is the North Carolina Industrial Commission. With the help of a trusted lawyer, you must submit a Form 33 to request a hearing. Your or your lawyer’s presence is needed to discuss your claim.
  • Step 3: If the commission denies your claim again, you can take it further to the Court of Appeals.

Remember that your employer’s workers’ compensation insurance covers most workplace injuries. According to the North Carolina Workers’ Compensation Act, businesses in the State must have workers’ compensation insurance if they have more than three employees. The insurance guarantees that employees can receive appropriate medical treatments if they get hurt or sick while fulfilling their work.

Still, it is possible to have workers’ compensation claims denied for varied reasons. One of the most common reasons for this is the timeliness of the claim. The insufficiency of evidence that the injury happened at work can also contribute to this decision. It is best to seek a lawyer’s guidance to ensure you get the compensation you are legally owed.

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