Mistakes That Can Lead to Denied Workers’ Comp Claims

A wide variety of different mistakes can lead to your workers’ comp claim being denied. Having your workers’ comp claim denied can prevent you from receiving the care you need.

By learning about common mistakes that can lead to a denial, and speaking with a Mississippi workers’ comp lawyer, you may have an easier time obtaining the care you need.

How often are workers’ comp claims denied?

If your workers’ comp claim was denied, you are not alone. Per reports from the Mississippi Workers’ Compensation Commission, Workers’ comp claims are filed every year in Mississippi. In 2022, 9,953 claims were filed, 2,156 of which were controverted. And, in 2023, 9,349 claims were filed, with 2,315 claims controverted.

In Mississippi workers’ compensation law, ‘controverted’ means the employer or insurer formally disputes the claim’s compensability (or specific benefits) by filing the appropriate notice or petition. When an employer disputes a claim, an employee may file a Petition to Controvert to start litigation.

What mistakes can lead to denied workers’ comp claims?

A variety of different mistakes can lead to your workers’ comp claim being denied. Some of these mistakes are as follows:

• You did not report the injury to your boss/supervisor right away.
• You provided inaccurate information on one of the workers’ compensation forms.
• Your boss/supervisor failed to report the injury.
• You did not provide medical evidence.
• Your workers’ comp forms are missing key details/were incomplete when you filed them.
• You did not provide a description of how the injury occurred, or the description was too vague.
• You waited a long time, after the accident, to see a doctor.
• You did not follow your doctor’s advice and/or didn’t attend follow-up appointments.
• You filled out one of the forms incorrectly/didn’t abide by the form’s instructions.
• You did not notify your employer of your workplace injury within 30 days, ideally in writing.
• You did not file a workers’ comp claim within two years of the injury.

How can you prevent your workers’ comp claim from being denied?

You can prevent your workers’ comp claim from being denied by doing the following:

• Read every form/document thoroughly and follow each instruction down to the letter.
• Work with a lawyer who can walk you through the entire workers’ comp process.
• Report your injury to the appropriate boss/supervisor as soon as you possibly can.
• Get this report in writing from your boss/supervisor, and make sure to hold onto it.
• Visit a doctor as soon as you can and hold onto all of the documentation that comes from this appointment.
• Tell your doctor exactly how you feel and what happened, so that they can properly document your injury.
• Write down your memory of the accident and be as thorough/detailed as possible.
• Journal about your symptoms using dated entries that clarify what you are experiencing.
• Use photos/videos to record your symptoms, as well as the injuries that are creating these symptoms.
• Follow your doctor’s advice and attend every follow-up appointment.

Even if you do the above, your workers’ comp claim could be denied. But if it is, you still have a few options.

What should you do if your workers’ comp claim is denied?

File a Petition to Controvert

If your workers’ comp claim is denied, you can file a Petition to Controvert with the Commission to dispute the claim within two years from your date of injury. In your petition, you must provide details regarding the injury you sustained and the medical treatment you received. After you file the petition to controvert, a judge will be assigned to your case.

Negotiate with the other party

You and the other party could enter negotiations. During these negotiations, you will make your case. And, the other party will make their case.

If the negotiations go well, your workers’ comp claim is more likely to be approved. But if these negotiations do not go well, you may receive less than you are asking for.

To obtain the best possible outcome through these negotiations, you may want to work with an experienced workers’ comp lawyer. Your lawyer will negotiate for you, using their legal knowledge to get the care you are asking for.

Attend a hearing for your claim

You and the other party may forfeit negotiations entirely, depending on the judge’s assessment of your appeal. If this is the case, you will be asked to attend a hearing for your claim. The other party will attend this hearing, as well.

During the hearing, you and your lawyer will be asked to present evidence that supports your need for workers’ comp. The other party will present evidence that supports their claims, as well. This evidence can encompass medical documentation from your appointments, witness testimony, and video/photo records, among other things.

After the hearing, the judge reviews the record and issues a written order. You may be granted the workers’ compensation you have asked for. Or, you may have your request denied.

Appeal the judge’s decision

Even if the judge denies your workers’ compensation request, you still have one more option: filing an appeal directly with the Mississippi Workers’ Compensation Commission within 20 days of the judge’s order.

During the appeal, you must tell the Commission why you disagree with the judge’s ruling. The other party must do so as well.

Speak with a Mississippi workers’ comp lawyer today

You have the right to appeal a workers’ comp claim denial. Contact Merkel & Cocke, P.A. using this contact form. We are ready to help you obtain the care you need.