You give your blood, sweat, and tears every day at work. So when you’re injured on the job and your claim gets denied, it’s a real slap in the face. This guide will walk you through the next steps to take after a denied workers comp claim, with the help of an experienced Mississippi workers compensation attorney.
Understanding Why Your Workers Comp Claim Was Denied
Your claim may have been denied due to insufficient medical evidence. The insurance company needs detailed reports from your doctor documenting your work injury. Make sure your doctor has provided notes on your diagnosis, test results, treatments, restrictions, and prognosis.
The insurance company may argue that your injury was not work-related. You’ll need statements from co-workers who witnessed your accident and records of any reports made to supervisors. Your doctor should also provide an opinion on how your work activities caused or aggravated your condition.
Failure to cooperate with insurance companies’ requests can lead to a denied claim. Be responsive to calls and letters, provide requested documents promptly, and attend all scheduled medical examinations.
Gathering Medical Evidence to Support Your Claim
If your claim was denied, don’t despair. You have the right to appeal; gathering solid medical evidence is key. Ask your doctor for detailed diagnosis, treatment, medications, and prognosis records. Get statements from any specialists you’ve seen as well. The more evidence you have that your injury occurred at work, the stronger your appeal will be.
Consult With Your Treating Physicians
Sit down with your doctors and explain that you need their support appealing your denied workers comp claim. Ask them to provide written statements confirming that, in their medical opinion, your injury was sustained at your workplace. Be sure to get statements from all doctors involved in your treatment.
Request Your Medical Records
Obtain copies of your medical charts, test results, surgical reports, therapy records, and anything relevant to your work injury. These records should clearly show your condition’s diagnosis and course of treatment. Highlight or flag any entries that specifically reference your work injury.
Get Witness Statements
If co-workers witnessed your accident or can attest to the circumstances surrounding your injury, ask them to provide written and signed statements supporting your claim. Their eyewitness accounts can be very persuasive evidence for your appeal.
Identifying Witnesses to Strengthen Your Case
To increase your chances of overturning a denied workers comp claim, search your memory for any witnesses who can testify on your behalf. Co-workers who saw your accident or injury are ideal, as are supervisors or customers who interacted with you before and after the incident.
Their testimony and accounts of events can help validate your claim. Reach out to former co-workers and explain your situation. Even if they didn’t directly witness the accident, they may have noticed a change in your behavior, mobility, or job performance around that time.
Appeal a Denied Workers Claim Within 30 Days
Once you receive the denial letter from your employer’s insurance carrier, you have 30 days to file an appeal in writing. Don’t delay; missing this deadline means you lose your right to appeal the decision.
Your first step is to request a reconsideration from the insurance carrier that denied your claim. In your appeal letter, specify why you believe their decision was wrong. If the carrier denies your claim after reconsideration, you can appeal to the Mississippi Workers’ Compensation Commission. You must file this appeal within 30 days of the carrier’s second denial.
Reach Out to an Experienced Mississippi Workers Compensation Lawyer
Appealing a denied workers comp claim can be complex, so having an advocate who understands the workers compensation system and knows how to navigate the legal procedures can make a big difference.
Our firm has years of experience handling Mississippi workers comp claims and appeals. We will review the specifics of your case and build an appeal strategy tailored to your situation. Call us today at 601-519-4181 to discuss your claim and next steps in overturning the denial.
