Denied Workers’ Compensation? Now What?

workers compensation denied

If you are injured on the job, whether in a work-related accident or by an occupational disease (like carpal tunnel syndrome), then you most likely have a workers’ compensation claim available in Louisiana. It’s important to know that the term “accident” is broader than a trauma, like falling down.  It can include hearing or feeling a “pop” in your back or neck, or something like exposure to dangerous gas.

If your claim for workers’ comp was denied, you may need a lawyer to help you determine the reason.  You could be denied for simply not meeting the eligibility requirements, such as getting injured while engaging in “horseplay” or while away from work. But if you believe the denial was reached in error, you may have the option to appeal.

Why Workers’ Comp Claims Are Denied

  • Injury was not reported as soon as it happens.  The more delay there is between the accident and the reporting, the more suspiciously the claim will be viewed.  Report any accident to your employer as soon as possible.
  • Claim was not filed quickly.  Even if you advise the employer of your work accident, you should also make sure that the employer sets up a claim with their worker’s compensation insurance carrier.  Again, the greater the delay, the more difficult it is to make a claim.
  • Employer disputes claim: The employer disputes the accident ever happened at work or disputes that your current injury/illness is a result of the accident (or exposure).  If this is the case with your claim, you may need to gather additional evidence to support your workers’ compensation claim. This can be witness accounts that the accident occurred or a statement from your doctor attributing your condition to your workplace.
  • “Horseplay” or intoxication.  If you were under the influence of drugs, medication, or alcohol at the time of this accident, then this could prevent you from making a claim.  Also, you were engaged in “horseplay,” that could also stop your claim.
  • Pre-existing injuries.  The employer may take the position that you were already had medical problems before the work accident.

There are plenty of other reasons why your workers’ comp claim may have been denied. The employer or its insurance company will sometimes look for whatever reason possible to deny a workers’ compensation claim. For an employer, denying a claim means decreasing insurance expenses and liability. Look at your claim denial letter, if one was provided, for the reason(s) your claim was denied, and talk to an attorney if you are still uncertain why your claim was denied.

Pursuing a Workers’ Compensation Claim After a Denial

If your claim is denied, you have the right to file a lawsuit against the employer with the Office of Worker’s Compensation.  There is a worker’s comp Court in Shreveport, which hears disputes over claims across Northwest Louisiana.

The first step to consider is contacting your employer or its workers’ compensation insurance carrier to discuss your claim denial and understand their reasons. If the denial was simply a matter of mistaken paperwork or other similar problems, the mistake could be cleared up and your claim may then be allowed. But if your employer still refuses to allow your claim, you may want to consult with an experienced lawyer.

A trial on the merits may take place before the administrative law Judge in Shreveport.  At the trial, you will be required to present medical and other factual evidence to support the existence of your workers’ compensation claim, and whether it is a work-related injury or an occupational disease. It’s important that you make sure your lawsuit is filed before the deadline, which is typically one year from the date of the accident, and that you have medical evidence to support your claim.

Speak With An Experienced Workers’ Compensation Attorney

You do not want to lose your rights to your workers’ compensation claim during your time of need. You should talk to an attorney before filing any lawsuit yourself.  A lawsuit is a complicated legal process, involving rules of evidence and civil procedure that the Judge will expect you to know. If you do not succeed at the initial levels, you will not be able to present additional evidence at subsequent appeal levels. One of the reasons that people lose their workers’ compensation claim is because they did not have an experienced workers’ compensation attorney at their side to help them prepare a strong case.

Don’t risk your opportunity to claim your right to workers’ compensation benefits if you are dealing with an injury that involves the loss of job performance or inability to work. We take our clients’ matters very seriously and understand the tremendous burden that is on you while dealing with an injury and medical bills.

Fischer & Procell have won many successful workers’ compensation claims for our clients in Shreveport / Bossier City – call us today for a free consultation.