Over 25 Years of Experience Serving The Quad Cities

What will you do if your workers’ compensation claim is denied?

On Behalf of | Feb 7, 2019 | Workers' Compensation |

Most employers in Iowa must carry workers’ compensation insurance to provide financial assistance to employees who suffer work-related injuries. Regardless of whether you work in a meatpacking facility, factory, warehouse, construction site or another industry, the no-fault insurance system will have your back — or will they?

Occupational illnesses or injuries can leave you without an income for weeks or even months. Your injuries could cause temporary or permanent disabilities that might jeopardize your ability to care for your family. If you face such a dire situation, you might have found out that there is no guarantee that you will receive workers’ compensation benefits.

Benefits claim denied?

If your employer or his or her insurer rejects your workers’ compensation benefits claim, you deserve to know your rights. A denied claim does not necessarily mean the end of the line, and understanding the following reasons for claim denials might help:

  • Eligibility: Your employer might claim that your injury did not occur while you were on duty, or that your participation in horseplay caused it.
  • Missed report deadline: The state of Iowa has specific requirements for you to report your injury to your employer or supervisor. If you missed that deadline, that could be the reason for the rejection.
  • Late filing of the claim: State laws require your employer to file your benefits claim. This period might be anything from 30 to 90 days, and missing that deadline could jeopardize your chances of receiving benefits.
  • Non-compensable injury: Some injuries a not eligible for compensation and proving conditions like occupational stress to be work-related could be challenging.
  • No medical expenses: Benefits typically cover medical costs, and if no medical bills accompany the claim, you might not receive benefits.
  • Not work-related: Your employer might claim that your injury occurred elsewhere and is not work-related.

A letter along with the denial might explain the reason, giving you the opportunity to appeal.

Should you file an appeal?

The letter that provides the reason for the rejection of your claim will also give a deadline for an appeal as determined by the laws of the state. However, this could be a complicated process, and securing legal counsel might help. An experienced lawyer could start the process with talking to your employer and his or her insurance provider before filing an appeal. It could be an easily resolvable dispute involving a misunderstanding or an administrative error.

Your attorney will know what procedures to follow under Iowa laws. The process might involve an administrative hearing through the Iowa workers’ compensation board or the labor department, and the appeals process might have multiple levels. Legal counsel will help you to obtain the necessary documents or medical reports, depending on the reason for denial of the claim. If successful, the appeal might lead to the full compensation to which you are entitled under state laws.


RSS Feed