Why Work Workers Comp Deny A Claim?
Workers’ compensation benefits can provide vital support for people who are hurt on the job in Portland and throughout Oregon. They allow employees who’ve suffered a workplace injury or work-related illness to receive medical treatment, partial wage replacement, compensation for permanent disabilities, and job retraining.
Unfortunately, some workers find that their initial applications have been denied. The reasons for denials vary, but it’s important to understand that you have the right to file an appeal and request a hearing if you believe you are entitled to benefits.
If you are struggling to get a workers’ compensation claim approved, you do not have to handle your application or appeal on your own. You can boost your chances of success by working with an experienced worker’s compensation lawyer.
Why Might My Workers’ Comp Claim Be Denied in Portland?
One of the most common reasons that workers’ compensation applications are denied in Oregon is because the applicant filed too late. Keep in mind that any worker who is injured on the job needs to report the injury to their employer within 90 days.
A report of an injury needs to be completed in writing, usually through the completion of Form 801 (Report of Injury or Illness on the Job). Employers typically provide Form 801 once they’ve been notified of an employee’s injury or illness.
The insurance company has 60 days from the date a person files their Form 801 with the employer to accept or deny the claim. An employer must report a claim to an insurance company within five days, and a health care provider is required to report a claim within three days.
Another common reason workers’ comp benefits are denied is the lack of an independent witness who can corroborate a victim’s version of events. Sometimes, the insurance company will deny a claim when they doubt the person’s story about how they were injured.
Another reason for a denial could be the presence of a controlled substance (drug) in an applicant’s system. In other cases, people have their claims denied because they refused to provide recorded statements to insurance companies or sign medical authorizations.
Some people find that their claim has been denied because they filed their application after being terminated or laid off.
In some cases, the insurance company might claim that the employee’s injuries were the result of a preexisting condition and could deny an application for worker’s comp benefits. There might also be a dispute over the severity of the injuries and the injured worker’s ability to return to work.
Do I Need a Lawyer in Portland to Fight for My Rights?
It is always a good idea to consult with an attorney before you file your workers’ compensation claim. An experienced lawyer can help you make sure that your application is filled out completely, which could help avoid a denial based on incomplete information.
If your claim has already been denied, contact a lawyer right away. Your lawyer can determine the reasons for the denial of your claim and gather evidence to support your appeal. This could include contacting people who witnessed the accident, speaking with your healthcare provider to create a more detailed medical report, or having an independent medical specialist evaluate your condition, for example.
You need an experienced lawyer by your side if your appeal needs to go before an Administrative Law Judge (ALJ), the Oregon Workers’ Compensation Board, or the Oregon Court of Appeals. Your lawyer can build a strong case and advocate for you.
How Can A Portland Worker’s Compensation Lawyer Help Me?
Do you need help getting workers’ compensation in the greater Portland area? Do not wait to contact Jodie Anne Phillips Polich, P.C.
Ms. Polich is a former member of the Oregon Workers’ Compensation Board with more than two decades of experience. Call us or contact us online now to receive a free consultation.
Jodie Anne Phillips Polich has been serving the needs of injured workers since 1993 and has developed a statewide reputation for the quality of her work.