A workplace injury is sure to create a host of issues for the hurt worker. However, things could become even worse if their claim is denied. Workers' compensation insurance is a valuable benefit for those with approved claims, but some may be denied their benefits if the insurer claims the worker had a preexisting condition. To learn more, read on.
Workers' comp insurers don't approve every claim and they use a variety of reasons for denying coverage. Part of the reason they are so strict is that the benefits are costly. For example, hurt workers with approved claims can expect to be covered for all related medical treatment costs along with a partial disability salary if the worker must stay home from work. After seeking medical treatment and filling out a claim form, some workers get a denial letter in the mail with a denial because of a preexisting condition.
Previous Medical Conditions
The claim form for benefits contains a section for hurt workers to list any previous injuries or medical conditions. If any of those conditions are similar to the most recent claim, the worker can be turned down. However, things are not necessarily over because of a denied claim. Unfortunately, few workers understand how things work and they never file an appeal.
Speak to an Attorney
Hurt workers should speak to a workers' compensation lawyer about their denial and they should act quickly. In many cases, workers have only a limited number of days to file an appeal. Workers' comp lawyers understand how the system works and they know what to do to get your benefits started. Moreover, they can assist you if your injury turns out to be permanent by negotiating with the insurer to obtain a fair settlement for you.
Key Factors in Overturning a Denial
The worker must be prepared to show that even if they did suffer from a condition in the past, the job injury or illness has made that condition worse. Preexisting conditions that are made worse by a job are covered under the insurance rules. For example, if you have an old knee injury, it could easily worsen if your job requires you to walk or kneel over the course of your day. You must show, however, that your previous injury had healed before you began working or that your situation has worsened considerably.
To find out more, speak to a workers' compensation lawyer about your injury.