My Workers' Comp Claim was Denied, What Do I Do Now?

You reported the injury. You went to the doctor. You filed the paperwork. Then the letter arrives saying your workers’ compensation claim has been denied.

What happened? Did you do something wrong? Are your medical bills now your responsibility?

If you were hurt on the job in Franklin or anywhere in Massachusetts, a denial is not the end of the road. It is the beginning of the appeal process. Understanding why the claim was denied and what comes next can make a real difference for you and your family.

Why Was My Massachusetts Workers’ Comp Claim Denied?

Under Massachusetts workers’ compensation law, injured workers are entitled to benefits if they were hurt in the course of their employment. However, insurers review claims carefully and often deny them for specific reasons. Common reasons include:

Insufficient Medical Evidence: The insurer may argue that your medical records do not clearly connect the injury to your job. This often happens with back injuries, repetitive stress injuries, or aggravations of prior conditions.

Late Reporting: Massachusetts law requires that you notify your employer of your injury as soon as practicable. Delays can raise questions, especially if there was no immediate accident report.

Disputed Work Connection: The insurer may claim the injury happened outside of work or was caused by something unrelated to your job duties.

‍Pre-Existing Conditions: If you had a prior injury, the insurer may argue that your current symptoms are not primarily related to your work.

The denial letter should explain the reason. Reviewing it carefully is the first step.

You Have the Right to Appeal in MA

In Massachusetts, workers’ compensation disputes are handled through the Department of Industrial Accidents. A denial does not mean you lose your rights. It means the insurer has refused to voluntarily pay benefits, and the matter must move into the formal process. Here is how that process generally works.

1. Conciliation: The first step is a conciliation, which is an informal meeting with a DIA conciliator. You, the insurer, and sometimes attorneys participate. The goal is to see whether the dispute can be resolved without moving forward.

2. Conference: If conciliation does not resolve the case, the next step is a conference before an administrative judge. Each side submits medical records and other evidence. The judge may issue a temporary order regarding benefits.

3. Hearing: If either side disagrees with the conference order, the case can proceed to a formal hearing. This is similar to a trial. Witnesses may testify. Medical evidence is presented. The judge then issues a written decision.

What Should You Do After a Denial?

Start by making sure your medical treatment continues. Gaps in care can weaken your case.

• Gather and organize:
• All medical records and doctor’s notes
• Any written accident reports
• Communications with your employer
• Documentation of lost wages

If there were witnesses to your accident, their statements can help clarify what happened.

In many cases, additional medical opinions are needed to clearly explain how your injury is connected to your work duties. Detailed, consistent medical documentation often becomes the key issue in an appeal.

How the Law Office of James F. White Can Help

James F. White has represented injured workers in Franklin and throughout Massachusetts for decades. He understands how insurers evaluate claims and where they look for weaknesses.

He will review your denial letter, explain your options in clear terms, and help prepare your case for conciliation, conference, or hearing. That includes working with doctors to ensure medical opinions fully address the legal standards required under Massachusetts law.

Workers’ compensation benefits can include payment of medical bills, a portion of lost wages, and compensation for permanent impairments. When those benefits are denied, the financial strain can affect your entire household.

You should not have to face that process alone.

Speak With a Franklin, MA Workers’ Compensation Lawyer at the Law Office of James F. White

If your workers’ comp claim was denied in Franklin or anywhere in Massachusetts, do not assume that the insurer’s decision is final. You have the right to challenge it.

‍Contact the Law Office of James F. White to discuss your situation and learn what steps make sense next. The sooner you understand your rights and begin preparing your appeal, the stronger your position can be.