Most injuries occur when least expected so the victim is rarely well prepared to bear the financial burden. This is only too common while in a workplace when obstacles get in the way or a worker is struck down by a work induced sickness. Fortunately, with most injuries and illness that occur while at work the financial cost comes from workers’ compensation. This covers both the cost of medical treatment and a proportion of the loss of income while recovering from the trauma. Workers’ compensation is available because your employer should have taken out appropriate insurance to cover these events. Sometimes the outcome of a claim is refusal to pay and this is when you may need an attorney to guide you through the appeal process. Blue Cross Blue Shield of Michigan Foundation – Company Profile This company was founded in 1939 and is a not for profit mutual insurance company. It is the biggest health insurance provider in Michigan, with 4.5 million customers in the state and 1.6 million in other U.S. states. It covers 152 hospitals, and at least 33,000 physicians with 8100 employees. The company crafts, sells and manages health plans for families, individuals, and employers who are based in Michigan. These include Medicaid plans, wellness plans, vision and dental plans. Tips to Help Handle a Workers’ Comp. Claim That Has Been Denied Tip#1. Look over the denial letter to confirm exactly what was the reason for the refusal to support your claim. Try and establish if you overlooked an important part of the evidence when you provided your documentation. If you are puzzled talk to a workers’ comp. attorney who will explain what you need to do next. Tip#2. Your employer or their insurer may be at fault. One of them might have not provided the whole picture related to the circumstances that caused your injuries. Often the right documentation has inadvertently been excluded from the claim on the part of your employer. These sorts of errors can be dealt with quite quickly. Tip#3. Timing is important with a workers’ comp claim and you must check to see if you filed your workers’ comp claim on time. If you did you should consider lodging an appeal but you should talk to a workers’ comp. attorney first who will tell you if you have a good case for filling and winning an appeal. Any workers’ comp. appeal has to be submitted within a certain time frame following your denial letter. Tip#4. Your attorney might tell you to gather together more documentation that includes more details about your injury. This is important if your employer has claimed your injury didn’t take place at work but you know it did. The time and place and a detailed description of the circumstances that caused your injury should have been recorded by the appropriate supervisor at the time of the event. Sometimes when it comes to paying for medical treatment the workers’ comp state board wants every little detail about the treatment and a breakdown of the costs. If you failed to provide sufficient detail you may have to run around the hospital and doctors who treated you to get more detailed documents before you have any chance of winning an appeal. Tip#5. Once you have launched your appeal you will be asked to attend an administrative hearing first. A judge will be present to listen to any evidence you provide that could lead to reversing the denial of your workers’ comp. decision. Use an Experienced WC Attorney if Appealing a Denied Claim So far you may have felt that you handled the workers’ comp. claim quite well but sometimes you need to get the help of an attorney if you intend to lodge an appeal as he or she will go that extra mile to ensure your claim denial is overturned and you get the compensation you are entitled to. This won’t be the first time your attorney has handled a workers’ comp. appeal, so you will get the best outcome by going through the appeal process. *The content of this article serves only to provide information and should not be construed as legal advice. If you file a claim against Blue Cross Blue Shield of Michigan, or any other company, you may not be entitled to any compensation.
