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When a worker submits a workers' compensation claim, but the claim is found to be insufficient, a Workers Compensation Denial Letter will need to be crafted. This letter will state why the company is submitting the Workers Compensation Denial and how the worker can contest the findings if they so choose. You will also need to supply the reasoning for the denial as part of their rights and as a safety measure should the employee pursue legal action. A Workers Compensation Denial Letter template can be downloaded below.
To write a Workers Compensation Denial Letter, include the following:
- The company's name and contact information as the header.
- The employee's name and mailing address.
- The workers' compensation claim number as the subject of the letter, along with language stating that the claim is denied.
- Opening salutation to the employee.
- Begin the letter by stating that the claim submitted by the employee on the date given has been denied by the company.
- State the reasons why the claim was found to be insufficient, such as incorrect facts of the case, witnesses who were unable to corroborate the facts stated in the claim, or a medical professional finding the employee was not injured as claimed.
- If the evidence submitted was found to be insufficient, provide a list of the Workers Compensation Denial Reasons and further information the employee will need to provide to have the claim reexamine.
- Provide the next steps the employee can take to resubmit their claim and the length of time they will have to contest the denial.
- Closing salutation.
- Your name, signature, and job title.
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