Can My Claim Be Denied If I Don’t Report the Injury in Time?

claim denied

Yes, there is a chance of denial, but the decision depends on various factors.
It’s mainly because workers’ compensation laws vary by state. But all states have a deadline for reporting a workplace injury or illness. The deadline period may differ between states, but the insurance company may deny your claim if you miss it.
Or you may end up receiving reduced benefits.
That’s why it’s essential to report your work injury as early as possible to avoid unnecessary inconvenience.

Situations Where You May be Eligible for Workers’ Comp Benefits

Workers compensation benefits claim

There are some cases where you will be eligible for workers’ comp benefits even if you miss the deadline.
For example:

  • Some states don’t always penalize you if your employer knew about the injury or illness before the deadline.
  • Suppose you think that you have a minor injury. In this case, you will want to wait for a while before seeing a doctor. And in the process, miss the reporting deadline.
  • As long as you submit appropriate evidence, the appeals judge considers this a valid reason for late reporting.
  • Your employer was aware or should have known about the injury or illness
  • Being in quarantine for a contagious disease
  • Your employer wasn’t affected by your missing the deadline
  • Your employer never posted notices regarding the company’s workers compensation rules
  • You have some other valid reason like being in incapacitation, and there’s no one to give information on your behalf

Statute of Limitations in the Different States

States like California and Florida have a 30-day deadline to appeal for a workplace injury. Some states like Iowa and Michigan have a statute of limitations of 90-days.
Then again, other states like Hawaii and Arizona don’t have specific deadlines. They just require that employers report the injuries as quickly or practically possible.
And in the case of Colorado, you lose a day of benefits for each day you are late if you don’t report the injury within four days.
So in the case of Glendale, you have 30 days to appeal.

What to Do in Case of an Appeal Denial

claim denied

You definitely shouldn’t give up if your case gets denied, especially if there’s a more legitimate reason than forgetting to send something or mailing it too late.
If you are late, you will receive a letter from the insurance company citing the reason for denial. Make sure you go through it thoroughly to find out on what basis you can appeal.
While it varies per state, your first option is to appeal in front of an administrative law judge. You can here provide evidence explaining why you hadn’t reported the injury on time.
Once again, depending on your state laws, there may be other appeal levels you can use. However, there will be a maze of rules and legal proceedings involved.
So it’s always better to have competent counsel with you through the appeals process. It’s better than taking the risk of making mistakes and eventually losing out on benefits just because you didn’t understand the process.

Who to Turn to for Help?

Lawsuit Vs. Settlement

One thing’s for sure is if your claim gets denied for not reporting on time. You don’t have an easy task in front of you. You are instead facing an uphill battle.
The best solution lies in turning to your workers’ compensation lawyer in Glendale for help.
And it’s better to do this as soon as possible. This gives your attorney time to protect your rights and benefits.
You anyway don’t have anything to lose. Most Glendale workers’ compensation attorneys don’t charge you until they win your case for you. They receive payment from the compensation amount you receive.

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