Dealing with a denied workers’ compensation claim
Knowing that workers’ compensation insurance is available to cover the costs of an injury and some of lost wages can relieve much of the anxiety a worker feels after an on-the-job accident in Minnesota. However, there are situations when the insurance denies coverage of a claim. This is not necessarily the end of the line, according to the Minnesota Department of Labor and Industry. A worker may still be able to receive benefits.
One of the keys to fighting the denial is reviewing the form from the insurer that explains why the claim was denied. The worker can then use the facts and reasons that are not correct to dispute the denial. The DLI’s Workers’ Compensation Division explains that the problem may be fixed with a simple phone call to the insurance claims adjuster to discuss the errors that were made. Documentation throughout the process is another important factor, so the worker should record the adjuster’s name and the date and time of the phone call, and take notes on what is discussed.
If the conversation with the adjuster is not successful, the worker should then speak to one of the DLI’s Alternative Dispute Resolution specialists. These specialists are available to explain the options for resolving the dispute and provide workers with information so they can decide what the best course of action is. The DLI also offers mediation services.
In cases involving a managed care plan, or if the worker belongs to a union, there may be a dispute resolution process specific to that situation.