Denied Workers' Compensation Claims
Here to Help If Your Claim Was Denied in Chicago
Your workers’ compensation claim should get you the benefits you need to recover after a workplace injury. However, you are not guaranteed workers’ comp benefits because the responding insurance company always has the right to see if your claim can be denied for one reason or another. Realistically, you should prepare for your case to be denied by the insurance company because the majority of them are denied after the initial filing.
McHargue & Jones, LLC in Chicago is here to help if your workers’ compensation claim was denied. Whether the denial is based on a legitimate reason or is the result of insurance bad faith tactics, our counsel is ready.
Workers’ Compensation Denial Reasons
It is never good to hear that your workers’ compensation claim has been denied. It is even more frustrating when it was denied without a valid reason. Let our Chicago workers’ comp claim denial attorneys evaluate the letter of denial you should have received. We can determine the reason for the denial and how to best challenge it.
Six common reasons for workers’ compensation denials are:
- You were not hurt in a way related to your work.
- Your injury is preexisting.
- Your injury did not require any medical attention.
- Your injury did not cause you to lose any wages.
- You did not provide enough information in your claim.
- You were not employed by the policyholder when the injury happened.
All of these reasons can be legitimate, or they can all be misconstrued to seem legitimate. When we are your chosen legal counselors, it will be part of our job to determine the denial’s legitimacy and take follow-up actions based on what we uncover.
What is a Non-Compensable Injury?
An injury that does not happen due to your occupation is a non-compensable injury in workers’ compensation law. When a denial happens, it is likely that the insurance company will try to argue that the injury was non-compensable. They might say that you were not clocked in, doing something unrelated to work, or intentionally acting recklessly at work when you were hurt. All of those situations could make your injury non-compensable, and your claim would be denied.
There are also certain injuries that are not covered by workers’ compensation at all. If you suffered such an injury, then your case could be in jeopardy.
Injuries not covered by workers’ compensation in most situations include:
- Mental health difficulties not directly caused by your work
- Self-inflicted injuries
- Injuries suffered while intentionally breaking safety protocols
- Injuries suffered while committing a crime
Who determines if an injury is compensable?
Typically, your employer will be the one to determine whether or not your injury is compensable according to the rules set forth by their workers' compensation insurance. If they are uncertain whether or not your claim is compensable, they should reach out to their workers' compensation adjuster and discuss the situation with them. If you feel that your employer is lying about the compensability of your injuries, reach out to our team of work injury lawyers today for help.
What Happens to Medical Bills When Workers' Comp is Denied?
If your claim is denied you will be held directly responsible for paying any medical bills. This can be a scary thing to face, especially if your injuries were serious and required an expensive surgery or extended hospital stay. Before you rush into anything, it's extremely important that you speak to a work injury attorney about your claim. Our attorneys can help you understand why your claim was denied, and if there's a way you can appeal the denial and still obtain compensation for your medical bills.
Need to Fight a Denied Claim? Call Us
McHargue & Jones, LLC proudly stands up for injured workers in Chicago. We can help you if your case has been denied for any reason. If your case was denied illegitimately, then we can challenge it in court and demand a settlement on your behalf. Even if it was denied for a valid reason, there might be other reasons as to why your claim should still be honored. Do not risk leaving money owed to you behind by going through your case alone. Let us represent you!