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What to do if your workers’ compensation claim is denied

On Behalf of | Apr 24, 2023 | Workers' Compensation |

Workers’ compensation insurance provides financial support for employees who have sustained injuries or illnesses related to their job.

However, there are instances where workers’ compensation claims get denied, leaving injured employees feeling overwhelmed and unsure of how to proceed.

Understand the reason for denial

The first step in dealing with a denied workers’ compensation claim is understanding the reason for the denial. The insurance company may deny your claim for various reasons, such as insufficient medical evidence, late reporting of the injury or a determination that the injury is not work-related. Carefully review the denial letter to understand the specific reason for your claim’s denial.

File an appeal

If your workers’ compensation claim gets denied, you have the right to file an appeal with the Missouri Division of Workers’ Compensation. To start the appeal process, you must complete and submit a “Request for Review” form within 20 days of receiving the denial letter. The form is available on the Missouri Department of Labor website and requires you to provide information about the injury, the reason for the denial and any supporting documentation.

Prepare for the hearing

Once you have filed an appeal, the Division of Workers’ Compensation will schedule a hearing to review your case. During the hearing, you will have the opportunity to present evidence supporting your claim, such as medical records, witness statements and any other relevant documentation. It is essential to prepare thoroughly for the hearing, as the outcome will determine whether your claim gets approved or denied.

Dealing with a denied workers’ compensation claim in Missouri can be a challenging and stressful experience. Remember to be proactive, gather all necessary documentation, and seek the support of your healthcare providers throughout the process.

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