Getting injured on the job is stressful enough without having to face a denial of your workers’ compensation claim. Unfortunately, this is a common situation for many workers in Iowa, Nebraska, and other states. When your claim is denied, it can feel like the system is working against you, leaving you without the financial support you need to cover your medical bills and lost wages.
This article will explore the reasons workers’ compensation claims are denied, the appeal process, and why hiring an experienced workers’ compensation attorney is essential to securing your benefits.
Common Reasons Workers’ Compensation Claims Are Denied
There are several reasons why workers’ compensation claims are denied, and understanding them is the first step in fighting back. Common reasons include:
- Failure to Report the Injury in Time: Workers’ compensation laws require that injuries be reported within a specific timeframe. In Iowa, workers must report their injury within 90 days, while in Nebraska, they must report it as soon as practicable.
- Disputes Over the Injury: Insurance companies may argue that your injury wasn’t work-related, or they may claim that the injury was pre-existing or happened outside of work.
- Insufficient Medical Evidence: If your doctor’s report doesn’t clearly document the connection between your injury and your job, the insurance company may deny your claim.
- Missed Deadlines: Filing paperwork late or missing deadlines for providing medical records can lead to a denial.
The Workers’ Compensation Appeal Process
When your claim is denied, the next step is to file an appeal. The process for appealing a workers’ compensation denial varies by state, but here’s an overview of what to expect in Iowa and Nebraska.
1. Filing an Appeal in Iowa
In Iowa, the workers’ compensation appeal process involves the following steps:
- File a Petition for Rehearing: If your claim is denied by your employer’s insurance carrier, you can file a petition for reconsideration with the Iowa Workers’ Compensation Commissioner. This petition must be filed within two years of the date of the injury or denial of benefits.
- Hearing Before an Administrative Law Judge (ALJ): If the petition is denied, the case may be heard by an Administrative Law Judge (ALJ), where both sides present evidence.
- Further Appeals: If the ALJ denies your appeal, you may appeal to the Workers’ Compensation Commissionerand, eventually, to Iowa District Court.
2. Filing an Appeal in Nebraska
In Nebraska, the appeal process is slightly different:
- File a Petition with the Nebraska Workers’ Compensation Court: If your claim is denied, you can file a petitionwith the Nebraska Workers’ Compensation Court to review your case. You must do this within two years of the denial.
- Trial Before a Workers’ Compensation Judge: If the petition is accepted, a trial will be scheduled. You and your attorney will need to present evidence to prove that your injury is work-related.
- Appealing to a Higher Court: If the Workers’ Compensation Judge denies your claim, you may appeal to the Nebraska Court of Appeals or the Nebraska Supreme Court.
Why You Need an Experienced Workers’ Compensation Attorney
Navigating the appeals process can be complex, and insurance companies will have legal teams working to deny your claim. Hiring an attorney who specializes in workers’ compensation law is crucial for several reasons:
- Familiarity with the Process: Workers’ compensation attorneys are familiar with the state-specific laws and deadlines, ensuring that your appeal is filed correctly and on time.
- Dealing with Insurance Companies: Insurance companies are notorious for using tactics to delay or deny claims. An experienced attorney knows how to counter these tactics and negotiate on your behalf.
- Understanding Medical Evidence: Workers’ compensation claims rely heavily on medical evidence. Your attorney can work with your doctors to ensure that your medical records clearly demonstrate the connection between your injury and your job.
Client Takeaway: Don’t Face a Denial Alone
If your workers’ compensation claim has been denied, don’t face the fight alone. At Ironclad Injury Law, we specialize in workers’ compensation cases and have a deep understanding of how insurance companies operate in Iowa, Nebraska, and beyond. We know how to build a strong case and fight for the benefits you deserve. Contact us today for a free consultation and take the first step toward getting the compensation you need.
