The Bureau of Labor Statistics (BLS) reports that nearly 70,000 people were injured on the job in Arizona in 2022. As state law mandates that employers must have no-fault workers’ comp coverage, any worker who has hurt on the job has the right to file for benefits. Unfortunately, that does not mean that a claim will be automatically approved. Quite the contrary, workers’ comp claims can be denied for a wide variety of reasons. At Snow, Carpio and Weekley, PLC, we help injured workers navigate appeals. Here, our Arizona workers’ compensation lawyer highlights six of the most common mistakes that you should avoid if your workers’ comp claim was denied in Arizona.
Mistake #1: Giving Up (Do Not Assume an Initial Denial is the End)
There are few things more frustrating than learning that your workers’ compensation claim has been denied by the insurance company. It can be completely dispiriting—especially when you need financial compensation to pay bills and support your family. Here is the first (and most important mistake to avoid: Do not give up. If your workers’ compensation claim in Arizona is denied initially, keep the hope. A denial does not necessarily mean the end of your case. Quite the contrary, neither your employer nor the insurance company gets to make the final decision on your case. You have comprehensive appeals rights. Be proactive. Arizona law allows you to appeal a denial. An experienced Arizona workers’ comp lawyer can help you navigate all aspects of the appeals process.
Mistake #2: Failing to Understand the Specific Reason for Denial
When a workers’ compensation claim is rejected in Arizona, the insurance company is required to provide the claimant (injured worker) with a written denial letter. Here is what you need to do: Review this letter, understand this letter, and save this letter. Not understanding why your workers’ compensation claim was denied is a critical error. It is the insurer’s reasoning behind its denial that provides key details for your next steps. Of course, workers’ comp denial letters can be frustratingly vague in many cases. An experienced Arizona workers’ comp attorney can help you understand and address a denial letter.
Mistake #3: Poor Organization (Lack of Documentation of Medical Care)
Documentation is key to any workers’ comp appeal. By maintaining organized records, you will be in a far better position to bring a successful workers’ compensation claim on appeal. A common mistake is failing to document medical treatments thoroughly. Ensure you keep detailed records of all doctor visits, treatments received, and medications prescribed. You should also preserve any other information that you have related to your care. These documents are vital evidence to support your claim’s validity and demonstrate the extent of your injuries. Disorganized or incomplete medical documentation can weaken your Arizona workers’ comp appeal.
Mistake #4: Failure to Seek Professional Legal Representation
You do not want to go up against your employer or an insurance company alone. If your work injury claim has been delayed or denied in Arizona, you need a lawyer. Attempting to handle your workers’ compensation claim alone can be daunting and may lead to adverse outcomes. By hiring an experienced professional who specializes in workers’ compensation law in Arizona, you will dramatically increase your chances for success. Along with other things, a top-tier Arizona workers’ compensation attorney can:
- Listen to your story and answer questions about the workers’ comp claims process;
- Conduct a thorough review of your denial letter—explaining what comes next;
- Gather and organize all supporting records you need to bring a strong appeal;
- Represent you in workers’ comp settlement negotiations with the employer/insurer; and
- Take your workers’ comp appeal as far as needed to maximize your financial benefits.
In Arizona, the workers’ compensation appeals process begins with a request for a hearing. The Industrial Commission of Arizona (ICA) will hear evidence/arguments from the parties. If the decision is unfavorable, an injured worker can further appeal to the Arizona Court of Appeals. Each stage allows for review and reconsideration of the case. A settlement could be reached between the parties at any point during the appeal process.
Mistake #5: An Angry Confrontation of an Employer
Your employer does play a key role in the workers’ compensation claims process. In some cases, an employer may try to challenge an injured worker’s initial claim. With that being said, confronting your employer angrily about your claim can harm your case. For this reason, it is important to maintain a professional demeanor and communicate effectively. Not only can hostility lead to strained relationships, it can potentially jeopardize your claim. Instead, focus on constructive dialogue and, if necessary, let your attorney handle communications. Once a workers’ comp claim is denied in Arizona, it is important to challenge that denial through the proper legal channel—a formal appeal.
Mistake #6: Not Continuing to Follow Your Doctor’s Advice
Finally, you should always put a strong emphasis on your health, safety, and well-being. Your physical and mental recovery matter. Be sure to continue following your doctor’s orders if you are not yet fully healed from the work-related accident. Doing so is important not just to protecting your health, it is also crucial for your appeal. Ignoring your doctor’s advice after filing a workers’ compensation claim can be detrimental. Follow professional medical advice and be sure to attend all appointments. Insurers look for reasons to deny claims—and non-compliance with medical recommendations can be seen as an indication that your injuries are not as serious as claimed.
Get Help From Our Workers’ Comp Attorney in Tucson Today
At Snow, Carpio and Weekley, PLC, our Arizona workers’ comp lawyers are skilled, solutions forward advocates for workers. A denial is not necessarily the end of the road. If your workers’ comp claim was denied, we are ready to help. Connect with us via phone at (877) 370-5788 or contact us directly online for your free case review. Our firm fights for the rights of injured workers in Tucson and throughout all of Arizona, including in Phoenix, Lake Havasu, and Glendale.
