Reasons for Denial Of Workers’ Compensation Claims

Workers Compensation Lawyers in Milwaukee

Worker’s Compensation Claims

Work injuries are stressful. You need financial compensation to pay your bills and support the people you care about. Unfortunately, in some cases, workers’ comp claims are denied by the big insurers. If your claim was denied, you have the right to file an appeal. In this article, our Milwaukee work injury attorneys highlight five common reasons why workers’ comp claims are denied in Wisconsin and we explain what you need to do to appeal an unfavorable decision.

Why Workers’ Comp Claims Are Denied in Wisconsin

The Injury Was Not Reported in a Timely Manner

You must report your accident/illness to your supervisor without unreasonable delay. As noted by the Wisconsin Department of Workforce Development, failure to notify your employer could undermine your ability to recover benefits. An insurer may use it as a reason to deny a claim.

You Never Received Professional Medical Attention

Injured workers should see a doctor as soon as possible. Not only is this crucial for their own safety, but it will allow for the easier recovery of workers’ comp benefits. If you do not see a doctor, you may not be able to bring a claim.

The Injury or Illness Was the Result of a Pre-Existing Condition

A workers’ compensation claim could be denied on the grounds that an injury or illness is a pre-existing condition. To be clear, a pre-existing injury exacerbated by a work injury is covered by Wisconsin workers’ comp insurance.

The Injury Did Not Happen at Work

To recover workers’ comp benefits, you must establish your injury happened in the workplace. Injuries that occurred off the physical premises of your employer may still be covered. Under Wisconsin law (Wis. Stat. § 102.03(1)), workers must prove that they were hurt in the ‘course and scope’ of their employment.

Your Employer Disputes the Claim

Finally, it is important to emphasize that employers can dispute workers’ compensation claims for a wide variety of reasons. If your employer disputes your claim, your benefits may be denied, and you may need to file an appeal to get the compensation you are owed.

You Have the Right to Appeal a Workers’ Compensation Denial

When a workers’ comp claim is denied in Wisconsin, the insurance company must send a written notice. Among other things, that notice should briefly explain the reason for denial and lay out the steps that you need to take to appeal the decision. To start, you have to request a hearing from our state’ workers’ comp division. If you received a denial letter, an experienced workers’ comp lawyer can help you build a strong appeal to get the benefits that you deserve.

Call Our Milwaukee Workers’ Comp Denial Lawyers Today

At Gillick, Wicht, Gillick & Graf, our Milwaukee workers’ comp attorneys are aggressive, experienced advocates for injured workers and their family members. If your workers’ compensation claim was denied, we are more than ready to help. Contact our Milwaukee office today for a free, no-obligation consultation. We handle workers’ comp appeals throughout Wisconsin, including in West Allis, Waukesha, Racine, Kenosha, Menomonee Falls, Janesville, Fond du Lac, and Sheboygan.