Reasons Your Louisiana Workers’ Comp Claim Could Be Denied
If you get injured on the job, you should expect to receive workers’ compensation. It wouldn’t be fair for you to have to suffer your injuries yourself. Your employer’s insurance should be responsible for your medical care. They should also pay your weekly replacement wages until you recover from your injuries.
Unfortunately, not all workers’ comp claims are approved. Your employer may tell the insurance company to deny your claim. If this happens, you need a Louisiana workers’ compensation lawyer to help file your appeal. This won’t be easy.
On the other hand, most workers’ comp claims are approved. For the most part, employers want to take care of their employees. If you work hard and get hurt at work, your employer has no reason to punish you. They have the insurance to cover your injuries.
To be covered under workers’ comp in Louisiana, you have to meet certain requirements. These requirements include:
- You were working within the scope of your employment
- You followed all company policies regarding workers’ comp
- The injury took place while you were on the clock
- You were treated by the company approved doctor
- You followed all your doctor’s recommendations
- There was no influence of drugs or alcohol at the time of your accident
As long as you meet these criteria, your workers’ compensation claim should be approved. There’s no guarantee that it will be approved. The insurance company could deny your claim for any number of reasons. If this happens, you should speak with a Louisiana workers’ comp attorney so they can help you get it approved.
Why Would Your Claim Be Denied?
Insurance companies and employer deny workers’ comp claims for a variety of reasons. Legally, they do need an actual reason for the denial. This information will be provided to your Louisiana workers’ comp lawyer.
Once your lawyer has this information, they can try to appeal your claim. They’ll reach out to your employer or the insurance adjuster. They’ll try to negotiate payment of your claim. At a minimum, they’ll demand that you be provided with the medical care you deserve.
So, why would your claim be denied?
- You didn’t file your claim by the due date
- Your employer doesn’t think the injury happened at work
- You didn’t follow protocol or didn’t wear personal protective equipment at the time of your injury
- There could be a clerical error on the claim paperwork
- You got hurt on purpose in order to collect workers’ comp
- You were drunk or high at the time of the accident
Appealing your claim isn’t easy. It can be complicated and time consuming, This is why you’re better off letting your Louisiana workers’ compensation lawyer handle this for you.
The Appeals Process in Baton Rouge
In order to appeal your workers’ comp claim in Baton Rouge, your lawyer will take the following steps:
- Request a hearing before a workers’ comp judge – you must do this in writing
- File a Disputed Claim for Medical Benefits if your medical treatment has been denied as well
- The insurance company has 14 days to respond
- You’ll have the option of going to voluntary mediation to try to resolve your claim
- If mediation doesn’t resolve the dispute, you’ll attend a workers’ comp hearing
Your attorney must provide evidence showing why your claim should be approved. This can include all sorts of things, including:
- Medical records
- Witness statements
- Information provided by your coworkers and managers
- The accident or incident report
- Your testimony or statement
- Proof that you didn’t have a pre-existing condition
Hopefully, your lawyer will be able to get your claim approved. If this happens, you’ll start to receive your weekly benefits in a week or so. Keep in mind, it could take some time for the appeal to be resolved. Make sure you continue to get treated for your injuries while your appeal is pending.
Call a Louisiana Workers’ Compensation Lawyer
If you get injured at work, you should call a Louisiana workers’ compensation lawyer right away. You have no idea if your claim is going to be approved or not. The last thing you want to do is try to handle this yourself.
Some people trust that their employer or Human Resources manager has their best interests at heart. While this may be true, it’s not always the case.
Call today and schedule your initial consultation with a Louisiana workers’ compensation lawyer. The consultation is free and you pay nothing until you win your case.