Most employers carry workers’ compensation insurance to cover workers if they are injured on the job, whether it be an accident that caused the injury or the development of a health condition such as hearing loss as a result of performing the job.
The Workers’ Compensation Process
When you are injured at work, seek medical attention promptly to document your injury. Follow-up by notifying your employer both verbally and in writing within 90 days of the injury to apply for workers’ compensation benefits.
Your employer will submit the necessary forms which will include details regarding how the injury occurred, treatment you have received, the prognosis, and also information about your income and hours to calculate your benefits.
Once approved, the insurer will contact the injured worker who will begin to receive benefits. If you are denied, an attorney can help you with an appeal.
Reasons for Denial
A very common reason for denial of workers’ compensation benefits is a failure to notify an employer within the 90 day window following an injury. Not providing required documentation such as medical records, diagnoses and medical opinion, or filing an otherwise incomplete application can also result in denial.
Workers may also be denied if an employee is off the clock, not following company policy, or committing a crime when they are injured in the workplace. Generally speaking, injured workers qualify for workers comp benefits if they are injured while at work, performing the duties of the job.
Another common reason for denial is if an injured worker has a preexisting condition. However, if your employer was aware of the preexisting condition and it grew worse as a result of performing your duties, benefits may be payable.
Although most employers do provide workers’ compensation, some are not required to provide the benefit. Ineligible workers such as certain domestic employees, independent contractors, agricultural laborers, and members of LLCs may wish to work with an attorney to pursue other types of compensation.
What Can I Do If MY Claim is Denied?
If it is a matter of missing documentation, submitting the necessary documents will usually result in benefits being approved. If you believe your insurer has acted in bad faith – not investigating your claim or withholding benefits you’re entitled to – your benefits may have been wrongfully denied. At this juncture it is crucial to work with an experienced workers’ compensation attorney who will file an appeal to get the benefits you deserve. If you have questions regarding workers compensation, contact the Davenport, Iowa workers’ compensation lawyers of McDonald, Woodward & Carlson for help at 563-355-6478.