If you sustain an injury or contract an illness as a direct result of your job, you should report it to your employer as soon as possible. They will complete a first report of injury and forward it to their insurance company. The insurer will obtain more information about your case before compensating you.
But what if the insurer denies your claim?
Here is what to do if this happens:
Determine why the claim was denied
The letter you receive from the insurer will explain the reason for the denial. Understanding why your claim was denied is key to determining your next steps.
Common reasons for denial include the injury is not work-related, an injury was reported too late, incomplete/inaccurate documentation or failure to seek medical attention.
Note that bad faith insurance is not uncommon. Thus, despite your employer’s insurance providing a reason for the denial, they may be trying to escape their obligation.
File a disputed claim for compensation
Workers have the right to appeal a denial decision. In Louisiana, you can file a disputed claim for compensation. You will complete form LWC-WC 1008 and file it with any of the ten offices of workers’ compensation in the state.
You will provide in-depth information about the accident/illness, the doctors/facilities that provided you with medical attention and so on. The state will then investigate your case to give a verdict.
Will your employer retaliate if you appeal?
It’s unlawful for an employer to retaliate against a worker for filing or appealing a workers’ compensation claim. Thus, your employer may not treat you unfavorably for doing so, and if they do, you can take legal action against them
With legal help, you can understand your options if you are denied workers’ compensation benefits.