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Claim Denied Archives

Workers Comp Claim Denied

A claim denied by the workers compensation insurance company requires that it let the injured worker know of his or her right to a hearing with the Department of Workforce Development. Wis. Admin. Code § DWD 80.02(2)(g)2. The worker should also receive a copy of any independent medical examiner or IME report. In serious cases, it is almost never practical or advisable for the worker to file for a hearing on his own. The insurance company and the employer have trained and experience professionals dedicated to defeating the claim for workers compensation benefits.

Claim denied for Pre-existing Condition or Degenerative Disease

Worker's compensation claim denied due to pre-existing condition and they never had a problem like this before.  The old pre-existing condition, and its cousin the catch-all degenerative disease, are the go to reasons insurance adjusters use to deny injured workers' claims.  Once in awhile these defenses have some merit, but mostly they are used unfairly by independent medical examiners, IME doctors, to deny legitimate claims.

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