What to Do if Your Workers’ Comp Claim is Denied Posted: July 20, 2025 Suffering a workplace injury is stressful enough—but receiving a denial on your workers’ compensation claim can feel like a punch in the gut. Unfortunately, while claim denials are more common than you might think, they don’t necessarily mean the end of the road. Whether your claim was denied due to a technicality or a dispute over the facts, you still have options—and legal rights. In this guide, we’ll walk you through exactly what to do if your workers’ comp claim is denied. We’ll cover the most common reasons for denials, how to start the appeal process, and how an experienced workers’ compensation attorney can help you protect your rights and your future. Table Of Contents Why Workers’ Comp Claims Get DeniedDon’t Panic—You Have the Right to AppealSteps to Take After a Workers’ Comp DenialPreparing for Your Workers’ Comp HearingWhat If Your Appeal Is Still Denied?You Don’t Have to Fight This AloneFrequently Asked Questions (FAQ) Free Case Evaluation Why Workers’ Comp Claims Get Denied If your claim was denied, the first step is to understand why. The denial letter from your employer’s insurance company should explain the reason for the decision. Common reasons include: Missed Deadlines: Failing to report your injury or file your claim within the legal timeframe. Lack of Medical Evidence: Insufficient documentation connecting your injury to your work duties. Disputed Injury Cause: Your employer or their insurer claims the injury wasn’t work-related. Pre-Existing Conditions: The insurer argues your condition was not caused or worsened by your job. Carefully reviewing the denial letter is essential, as it determines how you’ll proceed with your appeal. In many cases, denials can be successfully challenged with additional documentation or legal support. No Caption No Caption No Caption No Caption No Caption Don’t Panic—You Have the Right to Appeal A denial isn’t a dead end. Workers’ compensation laws in every state give injured employees the right to appeal. This process allows you to challenge the decision and present additional evidence supporting your claim. But be warned—deadlines are strict. Depending on your state, you may only have 30 to 90 days to file an appeal. Acting quickly is crucial to preserve your rights. Steps to Take After a Workers’ Comp Denial 1. Consult a Workers’ Comp Attorney Appealing a denied claim can be complex and overwhelming, especially if you’re also dealing with pain, missed work, and financial pressure. This is where a workers’ compensation lawyer can make all the difference. An experienced attorney will: Review your denial letter; Help you gather strong supporting evidence; File the necessary paperwork; Represent you in hearings and negotiations. Our law firm offers free consultations and works on a contingency fee, meaning we only get paid if you win. Free Case Evaluation 2. Gather Supporting Evidence Now is the time to build a stronger case. Work with your attorney to gather: Detailed medical records from treating doctors or specialists; Statements from coworkers or supervisors who witnessed your injury; Timecards or workplace reports proving your presence at work; Independent medical exams (IMEs) to verify the severity of your condition. Even small details—like photos of your injury or workplace conditions—can help. 3. File a Formal Appeal The process for appealing a denied claim varies by state but typically involves: Filing a Notice of Appeal or similar document with your state’s workers’ comp board; Attending a mediation session or pre-hearing conference; Presenting your case at a workers’ comp hearing before an administrative law judge. Each step has its own deadlines, forms, and procedures. Your attorney will ensure everything is filed correctly and on time. Preparing for Your Workers’ Comp Hearing If your case goes to a hearing, this will be your opportunity to present evidence, call witnesses, and testify about your injury and how it’s affected your life. The judge will review all materials before making a decision. Here’s how to prepare: Be honest: Stick to the facts and be consistent with what you’ve told doctors and your employer. Be prepared: Review your records, rehearse your testimony, and know what to expect. Let your lawyer lead: They’ll handle questions, cross-examinations, and objections. A well-prepared, well-supported hearing can turn your denied claim into an approved one. What If Your Appeal Is Still Denied? Even if your first appeal is unsuccessful, there may still be additional levels of appeal, depending on your state. You may be able to: File a second-level appeal with a higher board or court Apply for Social Security Disability benefits if your injury is long-term Explore third-party claims if another party (like a contractor or equipment manufacturer) contributed to your injury In rare cases, your attorney may advise pursuing a civil lawsuit, though this is only an option when workers’ comp coverage doesn’t apply or there was gross negligence. You Don’t Have to Fight This Alone Being denied workers’ comp is frustrating, painful, and confusing—but it’s not the end. With the right support, you can challenge the denial, protect your rights, and get the benefits you deserve. At Levin, Papantonio, we’ve helped countless injured workers appeal denied claims and win the compensation they need to recover and move forward. Our team is ready to listen to your story, review your case, and guide you through every step of the appeal process. Contact us today for a free consultation—and take the first step toward justice. Free Case Evaluation Frequently Asked Questions (FAQ) Q: How long do I have to appeal a denied workers’ comp claim?A: It depends on your state, but typically between 30 to 90 days from the date of denial. Don’t wait—talk to a lawyer right away. Q: Can I sue my employer if workers’ comp is denied?A: In most cases, workers’ comp laws prevent lawsuits against employers, but exceptions exist for gross negligence or third-party claims. Q: What if my employer says the injury didn’t happen at work?A: You can still appeal. Witnesses, medical records, and other documentation can help prove your claim.
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