After filing a claim for workers’ compensation benefits with the Industrial Commission of Arizona the employer’s insurance carrier will be “notified” of the claim. The insurance company is supposed to either “accept” or “deny” the claim within 21 days of receiving the ICA’s notification. If they deny the claim, they just have to check a box declaring that the claim is denied, they don’t have to list any explanation for their denial.
After receiving a denial without any explanation, an applicant for benefits will often ask “Can they do that?” The obvious answer is yes, that they can do that as evidenced by the fact that they have “done that.” The better question is “why did they do that?” I have compiled the following list of explanations for “why” a claim may have been denied (please note that each of the reasons may not be ultimately justified):
(Sung to the tune of 50 Ways to Leave Your Lover by Paul Simon)
It’s extremely important that a claimant file a “protest” or “request for hearing” within 90 days of the date of the denial notice. If the deadline is missed without a legal excuse, it doesn’t matter whether the denial was truly justified or not. The claim will be forever deemed denied regardless of the merits. If you believe a claim is wrongfully denied you should contact a qualified attorney or take action on your own behalf immediately.
Here is a link for a Request for Hearing Form:
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