Workers’ compensation is designed to cover medical expenses and lost wages after a job-related injury. However, severe injury claims, especially those requiring surgery or leading to permanent restrictions, often face denials. Insurance companies may argue that the injury is not work-related, the claim lacks sufficient medical evidence, or that a missed deadline invalidated the case.
Reviewing the denial letter
A denial letter explains why the insurer rejected the claim. Carefully reviewing this document is crucial. The letter may state that the injury does not meet the insurer’s definition of a severe work-related injury or that there were issues with the documentation. Understanding the specific reasons helps determine the best path forward.
Gathering strong medical evidence
A denied claim does not mean benefits are out of reach. Medical records, surgical reports, and physician statements play a key role in strengthening an appeal. A doctor’s written confirmation of how the injury impacts daily life and ability to work can provide essential proof. Seeking a second medical opinion may also help reinforce the claim.
Filing an appeal on time
In Minnesota, workers have 60 days to appeal a denied workers’ compensation claim by filing a Request for a Formal Hearing with the Office of Administrative Hearings. Missing this deadline can result in losing the right to benefits. The appeal process may involve submitting additional medical evidence, attending a settlement conference, and presenting the case before a compensation judge for a final decision.
A claim denial can be frustrating, but options exist. Medical evidence, proper legal steps, and persistence improve the chances of obtaining benefits. Injured workers should act quickly to protect their rights and secure the compensation they need to recover.
