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What do I do if my workers’ comp claim is denied?

On Behalf of | Jun 13, 2018 | Injuries, Workers' Compensation |

A workplace injury changes the course of your life. One minute, you are earning the money you need to support your family, and the next, you are in the emergency room wondering if you will even be able to return to your job in the same capacity.

Fortunately, Iowa’s workers’ compensation system provides support for injured workers. The higher the risk of your job, the more you may depend on the benefits offered, including lost wages and coverage of medical bills related to your accident. However, if you learn that the insurance company has denied your claim for benefits under workers’ compensation, you may wonder where to turn.

Why was my claim denied?

The rules for claiming workers’ compensation are rigid, and your employer should have that information readily available for you. Failing to follow those rules is a common reason why providers reject claims from injured workers. You may dispute the denial of your claim, but begin by asking yourself these questions:

  • Did you report the injury on time? Iowa law requires you to inform your supervisor of your injury within 90 days of the accident.
  • Did you file the claim before the deadline? Iowa law allows two years before you are ineligible to apply for benefits.
  • Is your injury among those that your employer’s insurance provider does not cover? For example, most insurers won’t cover injuries due to horseplay, fights with co-workers or injuries suffered if you were intoxicated on the job.
  • Did you seek medical treatment and complete all treatment instructions your doctor prescribed?
  • Did you submit sufficient evidence that your injury occurred on the job, such as eyewitness accounts or additional medical opinions?

Your employer may also dispute your application for workers’ compensation if he or she believes your injury is not work-related, is not as severe as you claim, or is the result of a pre-existing condition. Acting quickly in filing your claim and submitting as much corroborating evidence as possible can avoid these common reasons for denial.

What do I do now?

If the insurer denies your claim, the accompanying letter should outline the reasons. Using that information, you can build your appeal. You have a limited amount of time to file your appeal, and the best course of action is to take full opportunity of that time by gathering the evidence you need to dispute the denial.

Having legal assistance at this point, or any point in a workers’ compensation claim, is critical. An attorney can represent your cause before the appeals judge and help you explore all options for obtaining the compensation you need and deserve.


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