How Common Are Workers’ Compensation Claim Denials in Vermont?

If you’ve suffered an injury at work in Vermont, you might think that submitting a workers’ compensation claim is a simple process. After all, this system is intended to protect employees who are injured while performing their duties. However, the truth is that workers’ compensation claims aren’t always approved immediately. Denials occur more often than many workers realize. Understanding the reasons behind these denials can help you navigate the process effectively and protect your rights.

What Are the Workers’ Compensation Denial Rates in Vermont?

Vermont does not release specific statewide workers’ compensation denial rates as a single annual percentage. However, legal experts can confirm that these claims are denied regularly. Often, insurance companies scrutinize claims to protect their bottom line, leading to a significant number of claims being initially rejected.

Since Vermont is one of the smaller U.S. states, it means that the state may see fewer total denials than larger states. But, injured employees here still face a real possibility of having their claims rejected, especially after the first filing.

Reasons for Workers’ Compensation Claim Denials

According to the Vermont Department of Labor (VDOL), your employer’s insurance company must investigate your claim and determine whether to accept or deny it within 21 days of being informed about your workplace injury. If they choose to deny your claim, they must file a formal Denial of Workers’ Compensation Benefits (Form 2) with the Department and notify you.

Some of the common reasons for workers’ compensation claim denials in Vermont include:

• Disputes regarding whether the injury is work-related
• Insufficient evidence or documentation
• Late reporting
• Alleged misconduct or exclusions
• Employment status disputes
• Failure to seek prompt medical care
• Incomplete application

A Denial Doesn’t Mean the End of Your Claim

One of the key things to understand is that a denial does not necessarily mean the end of your workers’ compensation claim. Vermont’s workers’ compensation system gives injured workers multiple opportunities to challenge a denial, starting with informal discussions and, if necessary, moving through mediation, administrative hearings, and appeals before the courts until a final decision is reached. Many claims are initially denied but later approved, especially if newer evidence or documentation is provided. However, approval is not guaranteed.

How Can You Protect Yourself?

Luckily, there are steps you can take to reduce the chances of a workers’ compensation denial and strengthen your claim.

• Report your injury to your employer as soon as possible, even if it seems minor at first. Delays often raise red flags for insurers.
• Seek medical treatment promptly and clearly explain to your healthcare provider how the injury occurred at work. Medical records play a critical role in linking your injury to your job duties.
• Keep copies of all paperwork, including accident reports, medical records, and any communication with your employer or insurance company.
• Be cautious when giving written or recorded statements, as these can sometimes be used to challenge your claim.

Finally, if your claim is denied or delayed, an attorney who understands Vermont workers’ compensation law can help you protect your rights, gather necessary evidence, and pursue the benefits you are entitled to receive. Don’t hesitate to contact one.

Contact Sluka Law Firm

Are you facing a workers’ compensation claim denial? Contact our knowledgeable Vermont workers’ compensation attorneys at Sluka Law PLC for help ensuring you get the benefits you are entitled to.