Most workers' compensation claims get settled after being filed. However, in some instances, the claim may be denied, leaving the injured party to cater for their expenses without compensation. If your claim gets rejected, you can go to trial and appeal for further consideration by a judge. If you and your employer's insurer reach an impasse and fail to agree even in mediation, you may be forced to go into litigation. Below are the main factors that can lead to such a situation:
Disputes Over the Nature of the Injuries
For you to be eligible for workers' compensation, you must get injured in the course of your employment. If the other party disputes the manner in which you got your injuries, they may deny your claim. Issues that arise in this regard include the following:
In some cases, delayed injuries may also be a matter of contention, mainly if they occur when the claim has already been filed. In all these instances, a workers' compensation lawyer can help build a foolproof case to earn you the deserved compensation for the injuries.
Disputes Over the Amount of Claimed Benefits
There are various benefits that you can get after suffering a workplace injury. These include medical benefits, disability, missed wage replacement, and ongoing care costs. The amount you claim depends on the nature and severity of your injuries. If there is a dispute regarding this amount, the insurer may deny your claim. However, if you're confident that you deserve the benefits claimed, you can proceed to trial.
As you prepare for trial, it's paramount to note that you need solid proof of your injuries, how severe they are, and why you deserve the quoted amount. Your lawyer can engage expert medical professionals to substantiate the injuries and strengthen your case.
Claims Involving Mental and Chronic Illnesses
Numerous complications arise when settling a workers' compensation claim that involves mental and chronic illnesses. You may affirm that your mental illness is as a result of abuse or pressure at the workplace. You could also be suffering from chronic diseases that resulted from exposure to unfavorable conditions. These include conditions such as mesothelioma, which occur due to long term exposure to asbestos.
There has to be a direct connection between the injury and your work. In cases involving mental and chronic illnesses, you have a burden to prove that other external factors have not influenced your condition. Thus, this may cause your claim to be denied and force you into litigation.
These factors can complicate your workers' compensation claim and increase the risk of getting a denial. Talk to a compensation lawyer for legal advice and representation!
If you are in need of a workers compensation lawyer, contact a professional near you.
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