Workers’ Comp Claim Denied: Now What Do I Do?

Michigan lawyer discusses situations that lead to a workers’ comp claim being denied and how to protect your legal rights.

Workers’ Comp Claim Denied: Now What Do I Do?

Our job as work injury lawyers is to protect people who get hurt in the workplace. It seems like the deck is stacked against them because employers and insurance companies seem to hold all the cards. We try to make the game fair by educating people about their legal rights and helping them navigate the workers’ comp system. Employees who find their workers’ comp claim denied must file an Application for Mediation or Hearing (Form WC-104) and have the burden of proof.

We get frantic telephone calls from employees who have received a Notice of Dispute (Form WC-107) from their employer or its insurance carrier. This means work injury insurance benefits have been disputed. Unfortunately, employers and their insurance companies look for any dumb reasons to dispute a claim. Here is some information about legal rights that everyone should know.

Can an employer deny a workers’ comp claim?

Employers can deny (dispute) a workers’ comp claim if they believe to be invalid. This is usually based upon late reporting, witness statements, or medical evidence. A Notice of Dispute should be filed with the WDCA giving the reason. Watch out for employers or insurance companies who come up with bad excuses.

Late reporting is a bad excuse for a dispute. Employees actually have 90 days to give notice and 2 years to make a claim under Michigan law. Our experience also shows that witness statements are unreliable and should not be used as the basis for a dispute.

Medical evidence from a treating doctor is the gold standard when evaluating causation and disability. Watch out for employers who rely upon so called “independent” medical examinations.

What happens if a workers’ comp claim is denied?

Employees who find their workers’ comp claim denied will not have access to medical treatment or lost wages. This can lead to additional medical problems and financial distress. We recommend people in this situation use their group health insurance for continuing medical care.

A disabled employee needs continuing medical proof for their claim. Medical care ensures there is evidence about causation and disability. A treating doctor is also the best person to testify in a case.

What to do when your claim is denied?

Employees who find their workers’ comp claim denied should seek the advice of an experienced attorney. It is possible to file an Application for Mediation or Hearing and challenge the employer/insurance carrier dispute. A magistrate will decide if additional work injury insurance benefits should be paid and for how long.

Disabled employees cannot expect to win based upon common sense. Medical and vocational evidence must be developed and presented at trial. Specific procedures must be followed, and the rules of evidence will apply. Many of these cases are eventually settled for a lump sum cash payment.

Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (844) 201-9497 for a free consultation today.

Related information:

Injured At Work Who Pays Medical Bills?

Workers’ Comp Claim Denied: Now What Do I Do?
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