Getting the news that your claim was denied can be frustrating and even stressful because you're injured and living on benefits. Workers' comp denied notice doesn't necessarily imply that you are through with your case. Actually, many rejected claims in North Carolina can be petitioned or corrected through the right steps.
It's possibly self-evident, although most employees tend to read lightly through the denial letter and overlook some important information. The insurance company must state the reason why your claim was rejected. The most prevalent ones are the inability to meet deadlines, a lack of medical evidence, disagreement regarding the cause of the injury, or a non-work-related injury.
The reason behind the rejection will be known, and the most appropriate course of action can be established.
Claims with regard to workers' compensation in North Carolina have rigid schedules. You should move fast in case you appeal against the refusal. Failing to pay an appeal fee before the deadline may forever terminate your right to benefits, even if your injury is legitimate.
When you're denied, the first thing you should do is to take note of the date and immediately begin to get information.
3. Gather Medical and Work Evidence
Denied claims often come down to evidence. Reports regarding medical records, doctor notes, accidents, and witness reports can change or ruin your case. Ensure that your medical records indicate clearly how your injury is related to your job activities.
In case your employer or insurer tells you that your injury occurred outside of work, any evidence of the injury occurring at work can be of invaluable help.
4. Watch Your Words with the Insurance Company
Insurance adjusters would call you after a denial to find out more about you. Although they might appear to be beneficial, they're aimed at reducing payouts. Innocent remarks on the level of pain, on the ability to work, or on old-time injuries may be pulled out of context and used against you.
It's not wrong to be polite, but it's also not wrong to discuss only to a point when you are sure of what your rights are.
5. Take into Account Seeking Legal Advice
Most employees attempt to go it alone when dealing with the rejected claims and become discouraged in the process. The law of workers' compensation in North Carolina may be hectic, particularly when hearings and appeals are involved.
A competent workers' compensation lawyer would be in a position to study the denial, identify the many gaps in the insurer's case, and would also have a better chance of crafting a stronger case. There's a need, especially to consult a lawyer when you have been seriously or permanently injured.
6. Keep All Records Organized
Copies of all documents containing your claim, such as medical bills, e-mails, forms, and insurance company letters, should be saved. The fact that organized records facilitate quick and precise responses in making appeals makes this easier.
The refusal of workers’ compensation isn't the last. Many cases are not presented as some paperwork has not been done, evidence hasn't been lost, or there is no understanding. Acting correctly upon a denial, you'll be able to prevent your rights infringement and have better chances to receive what you deserve. Nobody should delay acting when they're informed and seeking help where necessary, since these next few steps can make a difference during a hard time.
