The news that your workers’ compensation claim has been denied is not only upsetting, but you start wondering why it was turned down. Although you get a letter outlining why it was rejected, it may not make sense because you’re hurting and need help paying your bills. We get that. At the Law Office of Jason M. Hatfield, we sit down with you and go over your claim, all documentation, and other information, and fine-tooth comb it. If you filed independently, we could review the filing for possible errors and for extenuating circumstances.
Administrative reasons for workers’ compensation claim denials
There are many reasons for your workers’ compensation claim to be denied. They include:
Limits On Circumstances Where Some Injuries are Compensable
For example, panic attacks are considered mental injuries. In Arkansas, such injuries may be covered if you can prove your panic attacks arose due to your employment by a “preponderance of the evidence.” Or, if you were a crime victim at work, you may be compensated for panic attacks. Death benefits may be paid if a loved one takes their own life within a year of developing a mental illness at work.
Additionally, Heart-related injuries due to stress at work may not be compensable. A heart-related injury resulting in death, injury, or illness is only compensable if an accident is the primary cause of the physical injury.
In Arkansas, worker’s compensation is an “exclusive remedy.”
This means an injured worker can only file a claim with the Worker’s Compensation Commission.
Most but not all Arkansas employers must purchase Workers’ Compensation Insurance. To be covered, injuries must be work-related.
An injury must have happened at work and during the performance of job duties. An employer may suggest the accident occurred outside of work.
Although missteps can happen along the way, it’s essential to understand what you should or should not do when pursuing a claim. The following examples could hinder your chances of obtaining a workers’ compensation claim without knowing it. Things you should not do when seeking a workers’ compensation claim in Arkansas include:
If you wish to obtain help for your injuries, speak with one of our attorneys as soon as possible. We bring more than 20 years of experience. We fight for our Fort Smith, Bentonville, Fayetteville, and other nearby communities to ensure the best outcomes. Contacting our office is the next best step to help ensure you receive proper medical benefits and pay for your time away from work.
You can apply for TTD. This category means an injury was sustained and it resulted in a non-permanent disability. The maximum time for TTD is 450 weeks, and the compensation is 66 and two-thirds percent of the worker’s gross average weekly wage. Since this rate increases every year, double-check the criteria to ensure you are receiving the full amount of what you are owed.
There is a seven-day waiting period before benefits kick in. If workers have been off work for over 14 days, they can receive benefits for the first seven days.
PPD stands for permanent partial disability, which is a benefit paid by your employer’s insurance company as provided by the Arkansas Workers’ Compensation Commission.
This refers to a situation where you have been assessed as having a permanent injury. A doctor will assign a permanent impairment rating, and the insurance company is responsible for paying the proper PPD rates once a treatment plan is completed.
If your workers’ compensation benefits have been suspended or denied, you may be able to file an appeal. One of the first routes to an appeal attempt is through mediation. Mediation typically involves your workers’ compensation lawyer, you, your employer, or the employer’s insurance provider. If things do not go well, there is the option to appeal to an administrative law judge.
Should the role of the administrative law judge be removed in this process, you may be able to appeal the decision. The process of an appeal claim varies depending on the circumstances of the case.
If the claims made to deny workers’ compensation are false, you have the right to appeal the decision. At the Law Office of Jason M. Hatfield, we are with you every step of the way.
The Law Office of Jason M. Hatfield, P.A. represents workers’ compensation claims from Northwest Arkansas, including Fort Smith, Rogers, Springdale, Fayetteville, Bentonville, Berryville, and Harrison. Call us today for your free consultation at (479) 361-3575.