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What to do about a workers’ compensation claim denial

If you suffer a workplace injury, you may come to find that you're unable to immediately return to work. This should lead you to file a claim for workers' compensation benefits.

If your claim is approved, you're in position to receive payments until you're able to return to work.

Conversely, if you receive a denial letter, you have some work to do.

Generally speaking, there are two things you can do about a workers' compensation claim denial:

  • Do nothing and miss out on the benefits owed to you
  • File an appeal

If you're interested in fighting back, here are a few things you should do:

  • Read the letter from beginning to end: Not only will your denial letter outline the reason, but it will also give you a clear idea of the next steps to take.
  • Find out why: Once you know why your claim was denied, you can better formulate a response. Common reasons include neglecting to report the injury in time, neglecting to file a claim in time, neglecting to receive medical treatment and your employer claiming you were not injured at work.
  • Immediately file an appeal: Don't wait to file an appeal, as you only have so long to do so, such as 30 days from receiving the denial letter. Once you know the reason for your denial, you can formulate an appeal to give yourself the best chance of having the decision overturned.

In some cases, a workers' compensation denial relates to a simple mix-up, such as a lack of documentation or a clerical error.

There are other times when a denial is much more complex, such as if your employer states that you didn't suffer the injury at work.

As you prepare to file an appeal, make sure you understand exactly what the process entails. For example, you may have to appear before an administrative law judge in the near future.

Since the workers' compensation appeals process is so complex, consider the benefits of consulting with an attorney. This gives you someone to lean on throughout the entire process.

Visit our website and read our blog for more information and advice pertaining to the Wisconsin workers' compensation system.

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We invite you to contact our office today by calling 414-727-7003 or by sending us an email to schedule a free initial consultation regarding your workers' compensation claim. We are located in Wauwatosa, Wisconsin. Our office hours are Monday through Friday from 9 a.m. to 5 p.m., and evenings and weekends by appointment. If we take on your case, we only charge fees when we obtain compensation for you.

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Paul M. Erspamer Law Offices, S.C.

Paul M. Erspamer Law Offices, S.C.
8112 West Bluemound Road
Suite 108
Wauwatosa, WI 53213

Phone: 414-727-7003
Fax: 414-727-7004
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