Why are Workers’ Comp Claims Denied in Baltimore, Maryland?
April 21, 2019
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If you get hurt at work, your employer should take care of you. You shouldn’t have to cover the costs of a work-related injury. And, for the most part, you won’t have to. Most work injuries are covered by workers’ comp insurance. Workers comp is intended to cover your medical care and offer replacement wages while you recover from your injuries.

In order to be covered under workers’ comp in Maryland, you need to meet certain requirements. Some of these requirements include:

  • Your injury took place while you were on the clock
  • You were working within the scope of your employment
  • You followed all company policies regarding workers comp
  • You were treated by the company approved doctor
  • You followed all your doctor’s recommendations
  • You weren’t under the influence of drugs or alcohol at the time of your accident

If you meet all of these criteria, your claim should be approved. But that doesn’t mean it will be. The insurance company may decide to deny your claim. If this happens, you need to call a workers’ comp attorney in Baltimore, Maryland immediately.

Reasons Your Claim Can be Denied

Your workers comp claim may be denied for a variety of reasons. When you get hurt, you’ll report your injuries to Human Resources. They will fill out the necessary paperwork and forward your claim to the insurance company. They will also let the insurance company know if they think the claim should be paid.

Indirectly, your employer will have a say in whether your claim will be paid. Even if they believe it should be paid, the insurance company may still deny your claim. They don’t want to have to pay more claims than necessary.

So, why would your claim be denied?

  • You didn’t file your claim by the due date
  • Your employer doesn’t think the injury happened at work
  • There could be a clerical error on the claim paperwork
  • You didn’t follow protocol or didn’t wear personal protective equipment at the time of your injury
  • You got hurt on purpose in order to collect workers comp
  • You were drunk or high at the time of the accident

If your claim is denied, you will have to file an appeal. This is why it’s important to have a Baltimore workers’ comp lawyer on your side.


The Appeals Process in Baltimore

The appeals process for workers’ comp cases is pretty straight forward. The problem is, it takes time. And, while you’re waiting for your claim to be processed, you won’t have any way to take care of your family. If you have a lawyer handling your claim, you improve the chances of being taken more seriously.

The first thing you need to do to file an appeal is request a hearing. You do this by filing something called an “Issues Form.” You have to make sure you mark off the reason for your denial and why you think it was incorrect.

You have to mail a copy of this form to the workers comp commission and your employer. Your workers’ comp attorney in Baltimore can do this for you. He’ll make sure you meet all deadlines and use the correct forms. He will also represent you at your appeals hearing.

Your attorney will submit proof that your claim should’ve been approved. After the commission hears both sides and considers all evidence, they’ll make a final decision. Your lawyer will receive a copy of the final order in the mail within a few weeks.

If your claim is approved, the order will state how much you are owed in benefits. If you or your employer disagree with the final order, you can ask for a rehearing within fifteen (15) days. Just keep in mind, getting the Commission to change their own minds is an uphill battle.

Call a Workers Comp Lawyer in Baltimore, Maryland

If you get hurt at work, you may need to call a workers’ comp lawyer in Baltimore. Most cases are approved and go rather smoothly. Other cases aren’t so easy. Sometimes, your employer has ulterior motives for denying your claim. They may think that you were hurt some other way than at work. Or, you have a history of filing claims in order to get time off from work.

With so much at stake, you really need a workers’ compensation lawyer in Baltimore. He can go to battle against your employer and get you the compensation you deserve.