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Why do insurers deny some workers' compensation claims?

There are many reasons that Wisconsin insurers might reject a workers' compensation claim you made. It is entirely conceivable that you could have made a mistake when filling out the complicated paperwork associated with workplace injuries. It would also be possible for something to happen behind the scenes with your employer or your insurer that could have prevented you from receiving the benefits to which you were entitled.

In fact, there are many potential causes for a rejected claim. Rather than ask why it happened, the most useful question in these circumstances would likely be what to do next. Handling a rejection correctly could have the dual effect of securing payment and revealing the source of the denial.

If you had a claim denied, one of the most important things to remember would be that you are not alone. Many injured workers get initial rejections only to go on to collect the benefits they need. The system in the state could provide you a choice between two initial paths towards this goal.

One of the first suggestions you might receive would be to take advantage of the Alternative Dispute Resolution unit. The Wisconsin Department of Workforce Development website states that you could use this official avenue if you did not have an attorney.

One of the issues with the ADR is that, regardless of the unit's efforts to negotiate and investigate informally, cases often end up at formal hearings. What this essentially means is that going through the state mediation procedures could waste some time compared to going right for a legal solution.

Every denial is different, just as every injury you might face in the workplace has unique characteristics. Therefore, please do not read this article as legal advice. It is only meant to inform you.

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