If you experience illness or injury while carrying out official work-related duties, you are entitled to receive workers’ compensation benefits. These benefits allow you to continue receiving income and help pay off your medical bills. However, if your claim is denied and you are unable to access those benefits, it can leave you in a very difficult position.

If this is your situation, you should speak to our experienced Findlay workers’ compensation denial lawyer at Schaffer & Associates. Born and raised in northwest Ohio, our workers’ comp attorneys are familiar with the hardships you may experience when facing a workers’ comp denial. Let us help you fight that denial and make things right.

Common Reasons for a Worker’s Compensation Denial

A claim denial can be an additional source of worry when you should be fully focused on recuperating so you can return to work. However, understanding why the claim was denied is crucial to finding a way forward. Some leading causes of workers’ comp denial include:

  • The worker waited too long to file the claim or failed to get immediate medical attention
  • The stated injury does not match the state’s qualifying injury types or was deemed not severe enough for a claim
  • The compensation claim was for pre-existing medical conditions or injuries
  • The worker’s actions led to the injury or illness (e.g., the actions leading to the accident and injury were directly linked to their inebriated state)
  • The company disputes the workers’ comp claim
  • Uncertainty about whether the employee developed the illness or experienced the injury while working
  • The employer incorrectly designated the employee as an independent contractor
  • The petitioner filed as an independent contractor, as workers’ comp benefits are only available to employees

Unfortunately, insurance companies are often eager to deny claims. Without legal help from an experienced workers’ compensation denial lawyer serving Findlay and the surrounding areas, injured employees may lose their opportunity to receive benefits.

Is There Any Recourse if a Worker’s Comp Claim Is Denied?

You may appeal a denial, but you must do so correctly. First, you must secure adequate proof of the error or unfair characterization that was the basis of the claim’s denial. Ohio’s Bureau of Workers’ Compensation will often state the reason for the rejection in the denial notice.

This proof may include medical documentation, time stamps, paper trails, worker app activity if any, evidence of work-related meetings or activity, witness statements—typically for coworkers—and other necessary information.

The goal is to ensure that you have considerable grounds for appealing the denial. Once you have ample evidence, the appeals process begins with filing an IC-12 (Notice of Appeal), followed by an administrative hearing before an administrative law judge at the nearest Ohio Industrial Commission in either Toledo or Lima.

The company will often be represented by its attorney, which means you should have a Findlay lawyer to argue your workers’ comp denial case before the judge. If the denial still stands after the hearing, you have the option of filing an appeal at the Hancock County Court of Common Pleas.

Consult a Workers’ Comp Denial Attorney in Findlay for Help

A worker’s compensation claim denial can feel stressful. However, with the help of our skilled Findlay workers’ compensation denial lawyer at Schaffer & Associates, you can successfully appeal the denial.

Our workers’ compensation attorneys serving Findlay and the surrounding area have extensive experience dealing with these kinds of cases and can help you reverse the decision where possible. Call today to discuss your options.