Understanding the complexities of workers’ compensation claims can be challenging, especially concerning occupational diseases. If you file a claim for an occupational disease in Wisconsin and receive a denial, it is essential to understand that while disappointing, it is not the end of the road. There are steps you can take to seek the benefits you deserve.
What is an occupational disease?
An occupational disease is a health condition that develops due to a work-related activity or environment.
For example, common occupational diseases include:
- Respiratory illness due to inhalation of toxic chemicals
- Strains due to repetitive physical activity
- Illness caused by exposure to hazardous materials
When you file a claim for an occupational disease, you must show a clear connection between the work you do at your job and the illness, which can sometimes lead to disputes and the denial of valid claims. Consulting with a workers’ compensation attorney can be essential in these cases.
Reason your claim was denied
The first thing to consider is the reason why your claim was denied. The same letter that tells you your claim was denied should tell you why. Reasons for denial of these claims include:
- You did not submit enough medical evidence linking your condition to your work.
- You did not submit your claim within the allowed timeframe.
- The insurer thinks a pre-existing condition unrelated to your job is what’s causing your condition.
- Wisconsin’s workers’ compensation laws do not cover the illness or condition.
What to do after receiving a denial
If your claim is denied, read the letter carefully several times to understand the basis of the denial. If possible, contact a workers’ compensation attorney who can guide you and could potentially help you appeal the denial.
If your claim was denied due to insufficient medical evidence, consider gathering additional medical information, including medical records from office visits, opinions from medical experts, and reports concerning workplace safety.
Filing an appeal
In Wisconsin, you can appeal a denied workers’ compensation claim. To do so, it is advisable to seek legal assistance. However, that is not a requirement. Appealing your denial involves filing a request for a hearing with the Wisconsin Department of Workforce Development within 30 days of your claim being denied.
Workers’ compensation appeals can be complicated to handle. Understanding why your claim is denied is the first step in seeking a reconsideration of your claim. Due to their complex nature, it is always preferable to have an experienced workers’ compensation attorney represent you.
