Insurance Company Denies Workers’ Compensation Claim

Workers’ Compensation

The insurance company denied my workers’ compensation claim, what do I do?

…If your workers’ compensation claim or injury has been denied, you probably need legal help right away. You should immediately contact a lawyer or an information and assistance officer (I&A) at the Workers’ Compensation Appeals Board (WCAB). You probably need to file an application right away at your local Workers’ Compensation Appeals Board with the help of a Workman comp lawyer in Madison. Again, you should immediately follow up with either a lawyer or with I&A. If you are unable to work and are in need of monetary assistance, then you should contact your local Employment Development Department and apply for State Disability Benefits. Medical care will also be a problem if the insurance company denies your case. Your doctor may be willing to give you treatment on a lien basis. In such a situation the doctor would submit a lien in your case and attempt to recover his or her treatment costs when your claim is litigated. If you cannot find a doctor willing to follow the lien procedure, then you should consider any private health insurance you have.

…If you are not working and your doctor is stating that you are too disabled to work, then you should be receiving temporary disability. The insurance company will only pay temporary disability if you have an accepted injury and your doctor is indicating that you are completely unable to work. Conversation is worth nothing in workers’ compensation. Your doctor must document that you are completely unable to work due to your work caused injury. Your doctor must state this in writing. If you are not working and not receiving any temporary disability, then you need to get a note from your doctor immediately. The insurance company will likely stop paying temporary disability if any doctor releases you to return to work or declares your condition permanent and stationary. If your temporary disability checks have stopped it is very likely that some doctor has declared your condition stationary or released you to return to work. Again, the main player in establishing your right to temporary disability is your doctor. If there is a dispute with the insurance company about your entitlement to temporary disability, then you may consider applying for State Disability Benefits (SDI) through your local Employment Development Office (EDD) until the dispute is resolved.

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