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Denied Workers’ Comp Claims

Are you the victim of a denied workers’ comp claim? Don’t fret; the team at Cardinal Law Partners can help remedy your denied workers’ comp claim and get you the compensation you deserve.

Most injuries sustained in the workplace are covered by an employer’s workers’ compensation insurance. States require employers to cover their employees’ potential injuries in accordance with the average level of risk that a particular industry may incur. Still, there are instances where a workers’ compensation claim will be denied. In the event of denied workers’ comp claims, one must first understand why the claim was denied and then decide what steps to take.

Reasons a Workers’ Comp Claim May Be Denied

The first thing to do in the event of a denied workers’ comp claim is to understand the reason for denial. This should be explicitly denied within the denial letter presented to the injured employee (or on the Form 61). Workers’ compensation claims may be denied for a variety of reasons that all relate to failure to meet eligibility requirements. Such reasons may include:

  • Injury not reported in time: In order for workers’ compensation claims to be approved they must be reported within the specified time, as dictated by each state. Within the state of North Carolina, an injury sustained at one’s place of work must be reported in writing as soon as possible, but no later than 30 days after the incident occurred.
  • Claim not filed in time: Different from an injury not being reported in time, a claim must also be reported within a state’s specified time requirement. Within the state of North Carolina, the Form 18 must be filed by the injured worker within 30 days of the injury. This form should be reviewed by an experienced North Carolina Workers’ Compensation lawyer, such as the ones at Cardinal Law Partners.
  • Employer’s dispute of a claim: An employer may claim that an accident happened outside of work, was a result of foolishness/horseplay or may cite another reason discrediting the employee from receiving just compensation.
  • No medical treatment required: In the even that no medical treatment is required in order to remedy the injury, a workers’ compensation claim may be denied when attempting to pursue benefits
  • Insufficient evidence that injury is work-related: If the evidence presented during the claim does not amount to enough to be proven that it occurred at work, a workers’ compensation claim may be denied.

What to Do If Your Workers’ Compensation Claim Is Denied

Once a workers’ compensation claim has been initially denied with a valid reason, the next step one may take is to file an appeal. This is best done under the guidance of an experienced workers’ compensation lawyer. Filing an appeal requires the injured employee to submit a Form 33, or a Request That Claim Be Assigned for Hearing, to the North Carolina Industrial Commission (NCIC). This form includes a description of the injury, a detailed outline of the benefits the worker is requesting, a list of witnesses and their contact information, and the reason the parties are unable to reach an agreement. It is advisable to seek adequate legal assistance in the form of a workers’ compensation attorney to help determine the best course of action, assist with timelines, ensure that all necessary documents are provided, and help the worker present the best possible case in order to win an appeal for a workers’ comp claims denial. Judges involved in such claims will expect an understanding of all legal proceedings and will be less likely to overturn an appeal if initial cases are presented in a weak manner.

If you or someone you know is involved in denied workers’ compensation claims case in North Carolina or South Carolina, call the team at Cardinal Law Partners today. We have an experienced group of workers’ compensation attorneys ready to help get you the legal support need. With offices in Raleigh, Greensboro, Charlotte, and Belmont, North Carolina, Cardinal Law Partners is the legal team you have been looking for.

Call Cardinal Law Partners today for a free case evaluation at 833-444-4257 or send us a message!