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Can I appeal a workers’ compensation claim denial in Kentucky?

On Behalf of | Jun 22, 2023 | Workers' compensation

Imagine working your tail off and never calling in sick only to suffer a severe workplace injury, which leaves you unable to perform your job duties for two weeks or longer. You file a workers’ compensation claim to stay financially afloat until you can return to work. But it’s denied by the Kentucky Department of Workers’ Claims. Now what? The good news is the process doesn’t have to end there.

Common reasons for claim denials

Kentucky allows workers two years to file workers’ comp claims, so missing the deadline is rare as most workers notify their employer promptly to replace missing income as soon as possible. If you get a denial from the state, the notice should explain why. Here are the three most common reasons:

  • Paperwork mistakes: Not including essential information about your injury or completing all required documents are the most common causes of rejections.
  • The injury wasn’t job-related: Some employers will contradict your claim telling the state that you suffered your injuries while off the clock.
  • Pre-existing conditions: Employers may also claim you suffer from a chronic condition or illness. This is often seen for claims related to neck or back injuries.

After receiving the rejection notice, the first step in your appeal happens during a benefit conference review, which includes your employer or their insurance carrier. While it’s not mandatory, it is advisable to consult with an experienced workers’ compensation attorney before this meeting.

Your lawyer will review the denial letter and help you gather the information you need for the appeal, including documentation from a doctor and witness statements from co-workers or others. It’s important to be prepared because if you aren’t successful at this hearing, the appeals process gets much more challenging.

Filing a claim correctly helps avoid lengthy appeals

Workers’ comp benefits usually replace about two-thirds of your wages while you cannot work. Benefits for approved claims typically begin after a seven-day waiting period. After two weeks, you’ll receive benefits retroactive to when you stopped working. Consulting a knowledgeable workers’ compensation attorney can save you a lot of time and effort to ensure you get the benefits you deserve.