In order to receive benefits to compensate for your work-related injury, your claim must be approved. The first instinct of your employer and their insurance company will likely be to deny the claim. This does not end the process, however, which is where an experienced workers’ compensation attorney comes in. They could help you fight back against a denial of a workers’ compensation claim in Glastonbury.
What is Needed to Approve a Workers’ Compensation Claim?
The injured employee needs to have a medical provider write an opinion stating the employee’s job was a substantial contributing factor to the injury and then describe the treatment they require. Once this is sent to the Connecticut Workers’ Compensation Commission (CWCC), they make out their prima facie case. In Glastonbury, it is the responsibility of the insurance company to decide whether to accept a workers’ compensation claim or issue a denial.
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When Would a Workers’ Comp Claim Be Denied?
In Connecticut, most workers’ comp claims are denied at the outset, like those seeking disability benefits. The employer typically declares that the employee did not meet their burden of proof that shows the injury happened at work or in work-related duties. They might claim that the full nature and extent of the injury is related to what happened at home or that the employee has some preexisting condition that is responsible for their injury or illness. The employer could claim that the employee was intoxicated or was technically not on the job at the time of their injury.
Any of these arguments are issues that employers’ insurance companies try to raise to prevent someone from being paid their compensation. Fortunately, a denial to a workers’ compensation claim in Glastonbury does not mean that the case is over.
First Step to Take After a Claim is Denied
The first thing a person should do after a claim is denied is get a free consultation with a workers’ compensation attorney in Glastonbury to advise them on the best way forward. A lawyer could look at the reasons for the denial and determine what is needed to help the injured worker prove their case and get the case accepted.
As a legal advocate, they could request an emergency or expedited hearing with a workers’ compensation commissioner to get benefits approved on a temporary basis while the claim and the denial are ongoing. The injured worker needs someone who can quickly analyze and understand why the claim was denied, how to get past it, and how to advise the worker so that they get the treatment they need and can pay their bills.
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Avoid Medical Treatment Denials
The best thing someone in Glastonbury can do to ensure that future medical treatment is not denied on their workers’ compensation claim is to listen to their doctors. Their doctor might order a follow-up appointment, prescribe medication or activities, or refer them out to a physical therapist. The worker has an obligation to accept reasonable and necessary medical treatment just like the insurance company and employer have an obligation to provide that reasonable and necessary medical treatment. The patient should not skip out on appointments or be lax about taking medications. These remedies cost the insurance company money and if they are not being used then the company will try to cease providing that compensation. Focusing on recovery is imperative.
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Speak To a Glastonbury Attorney About the Denial of a Workers’ Compensation Claim
It is common for a workers’ comp claim to be initially denied by the insurance company. If this happens, contact a lawyer immediately so you can begin the process of getting it approved by the CWCC. Do not let the insurance companies determine whether your claim is legitimate. You always have options after a denial of a workers’ compensation claim in Glastonbury.
