When a claim is filed with workers’ compensation insurance companies, it is not always accepted immediately. Insurance companies tend to require proof. Knowing what to expect from your provider can help you navigate the claims process more successfully. Here are three issues that could slow the process down.
1. What Compensation is Fair
Providers will often call for an investigation to determine whether or not an employee’s injury falls within the scope outlined in the policy. Sometimes, verification is needed that the accident occurred in the workplace while performing the job and that medical attention was necessary.
2. What Treatment is Required
Just because a doctor requests certain medical treatment, that does not mean that workers’ compensation insurance companies will automatically accept that assessment. If your doctor’s request is challenged, you can appeal the decision through a utilization review.
3. What Disability is Necessary
Injured workers are not always entitled to disability benefits. If your doctor does not indicate that you are unable to work as a result of your injury, claims for disability will probably be denied. Even if the doctor does suggest time off to recuperate, the insurance provider could require a second opinion.
Having a general idea about what to expect from workers’ compensation insurance companies when you are injured on the job is helpful. If you know what they require, you are more likely to provide the proof needed to get your claim accepted.