A workers’ compensation claim denial can feel overwhelming, especially when you rely on benefits to cover medical expenses and lost wages. If your claim gets denied in Tennessee, several steps can help you challenge the decision and pursue the benefits you need.
Review the denial letter
Start by reviewing the denial letter to understand why your claim was denied. Common reasons include missing paperwork, failure to report the injury on time, or disputes about whether the injury was work-related. Identifying the reason helps you determine your next steps.
File an appeal
If you disagree with the denial, Tennessee allows you to file an appeal. You must request a hearing with the Tennessee Bureau of Workers’ Compensation within one year of your claim’s denial. This hearing gives you an opportunity to present evidence and explain why your claim should be approved.
Gather evidence
Building a strong case requires evidence to support your claim. Gather medical records, witness statements, accident reports, or any other documentation that proves your injury occurred at work. Clear and thorough evidence strengthens your appeal.
Request mediation
Tennessee offers a mediation process through the Bureau of Workers’ Compensation to help resolve disputes. Mediation involves a neutral third party who facilitates a discussion between you and your employer’s insurance company. This process often leads to quicker resolutions than a formal hearing.
Seek a second opinion
If the denial involves questions about your medical condition, consider getting a second opinion from another healthcare provider. Additional medical evaluations can provide more evidence to support your claim and address concerns raised by the insurer.
A denial doesn’t mean the end of your workers’ comp case. By understanding the process, you can work toward securing the benefits you need to recover and move forward. Taking proactive steps increases your chances of a successful outcome.
