If you have been injured in a workplace accident, you may have attempted to pursue your own claim. You likely submitted a written statement to the employer and/or insurer, including copies of your medical records, and now you have been informed that your claim has been denied. Unfortunately, this is a regular occurrence and in most cases, it’s “business as usual” for the insurer to deny your claim. The insurer cannot deny your claim in “bad faith.” However, what constitutes a “good faith” reason to deny your claim is less than most people would realize. An insurer can deny your claim for something as trivial as a disagreement about the amount of your pre-injury wage.
The most important thing you need to understand in dealing with a workers’ compensation claim is that you do not have to accept the employer or the insurance company’s denial of your claim. Insurance adjusters routinely deny claims that are ultimately found to be compensable. You may have been told that your claim was denied because you “violated a safety rule” (that no one ever told you about) or that you were not “within the course and scope of your employment” at the time of the accident. They may also state that they “contest the nature and extent of your disability.”
Do not believe a word an insurance adjuster or risk manager tells you about why your claim was denied. Most of the time, they have little to no objective evidence that will hold up to scrutiny. In short, neither the employer, nor the insurer, has the legal authority to deny your claim unilaterally. You always have the ability to hold them to account through legal process.
In Virginia, all workplace injury claims are ultimately decided by the Virginia Workers’ Compensation Commission. If you have been told that your workers’ compensation claim has been denied, do not accept defeat. Our experienced attorneys can assist you in filing a claim with the Virginia Workers’ Commission to force the insurance carrier to pay you the compensation you are entitled to. We will assist you in all aspects of your claim including collection of your medical records, preparation of answers discovery requests, and hearing preparation.
In Virginia, a claim for workers’ compensation must be filed within 2 years of the date of the accident. Failure to file a timely claim will bar your claim for compensation. If an insurance company or your employer is denying you workers’ compensation, call our office to schedule a free consultation. We will help you get the compensation you deserve.