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Can An Approved Worker’s Compensation Claim Be Reversed?

by Grace

Every day, workers across the country suffer workplace injuries that can leave them unable to work and support their families. When this happens, those workers and their families are entitled to certain benefits through a worker’s compensation claim. 

But what happens if the insurance company or state agency handling the claim decides to reverse its approval? Let’s take a closer look at this situation and find out.

What is an eligible workers’ compensation claim?

An approved worker’s compensation claim is when a worker has been injured and is eligible for certain benefits such as medical care, wages, and other financial assistance. This type of benefit is available to both the injured worker themselves as well as their family members. The goal is to help provide financial security during a difficult time while ensuring justice is served for those who have been unfairly injured in the workplace.

How can a worker’s compensation claim be reversed?

Unfortunately, an approved worker’s compensation claim can be reversed if fraud or dishonest behavior has been discovered about the initial filing of the claim. For example, if false information was provided to receive benefits or if there was any evidence of intentional deception, then it may be possible for the insurance company or state agency handling the claim to reverse its decision.

What factors are considered? And who makes the decision.

When deciding whether or not to reverse an approved worker’s compensation claim, several factors may be taken into consideration. These include evidence of fraudulent behavior related to how the injury occurred or how much money was requested in benefits payments. Depending on your state, the decision will ultimately be made by either an administrative law judge or another designated official.

How do I appeal a reversed workers comp claim?

Suppose you believe that your injury was legitimate and that you should still qualify for benefits even after your case has been reversed by either an insurance company or state agency. In that case, you have the right to appeal with whichever court handles requests for your particular jurisdiction. This appeal process must happen within a specific timeline, so adhere strictly to all deadlines associated with filing your appeal paperwork. If you’re not sure about the deadlines, give your workers comp insurer a call and they’ll guide you through the process.

In Conclusion

All injured workers and their families need to understand that while it’s possible for an approved workers’ compensation claim to be reversed due to fraud or dishonesty being found, they still have options available if they feel like they were wrongfully denied benefits due to improper investigation practices or other reasons outside of their control.

If you believe that your case has been unfairly overturned after being initially accepted, then make sure that you file your appeal as soon as possible so that you can have your case reexamined by a higher authority and potentially get back on track with receiving your rightful benefits from here forward. Thank you for reading.

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