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How to handle a worker’s compensation claim denial

On Behalf of | May 5, 2022 | Workers' Compensation

Workers’ compensation in Providence, Rhode Island, pays a portion of your salary until you heal from a work-related injury. However, figures show one in 25 legitimate claims are commonly denied. You may take some steps if you feel you got unfairly denied.

Learn the reason for denial

A common reason for denied workers’ compensation claims is you missed the deadline to report the injury. You have 30 days to report an injury under Rhode Island law and give the employer written notice. The time frame commonly starts on the first day you miss work or it is diagnosed as a work-related injury.

The injury must be work-related or must have occurred during the scope of employment, which includes tasks that are part of your job. For example, if you get injured running an errand for your employer, you may get covered, but not on lunch breaks.

The injury or illness must qualify under the workers’ compensation guidelines for compensable injury and listed in the handbook. Injuries that resulted from intoxication, intentional injury, practical jokes, or roughhousing commonly will not get covered under workers’ comp.

File an appeal

The letter you receive from the workers’ comp board should have instructions on how to appeal a decision and denial reason. If you disagree with the board’s decision, you may file an Employment Petition for Compensation Benefits to request a hearing.

Gather proof to back up your claims, such as photographs, medical records, and past and present pay stubs showing lost wages. Your pre-trial conference is commonly scheduled 21 days after submitting the petition, and the court will assign a workers’ comp judge. If you disagree with the judge’s decision, you have five days to file a Claim for Trial.

Even if you can represent yourself, workers’ compensation laws are complex. A legal representative is your chance at the compensation you deserve.