Did you receive a “NOTICE TO CONTROVERT” from your Employer or its workers’ compensation insurer?
It’s a form that looks like this:
If you received a form like this, it means that they are not accepting responsibility for benefits. If you read section B of the form, it should tell you specifically what they are controverting. If you disagree with the controvert, then you must take timely action to oppose it. We handle these types if situations every day. Call us and we will help you navigate this situation.
There are several reasons why a workers’ compensation claim may be controverted, or disputed, by the employer or the workers’ compensation insurer. Some common reasons for controverting a claim include:
Lack of evidence: If the employer or insurer believes that there is insufficient evidence to support the claim, they may controvert it.
Pre-existing condition: If the worker had a pre-existing condition that contributed to the injury, the employer or insurer may argue that the injury is not covered by workers’ compensation.
Failure to report the injury in a timely manner: If the worker does not report the injury within the required timeframe, the employer or insurer may dispute the claim.
Non-work-related injury: If the employer or insurer believes that the injury did not occur on the job or was not caused by work-related activities, they may controvert the claim.
Dispute over the extent of the injury: If there is a disagreement about the severity or extent of the injury, the employer or insurer may controvert the claim.
Dispute over the appropriate medical treatment: If there is a disagreement over the appropriate medical treatment for the injury, the employer or insurer may controvert the claim.
Fraudulent or exaggerated claims: If the employer or insurer believes that the worker is making a fraudulent or exaggerated claim, they may controvert it.
It’s important to note that controverting a claim does not necessarily mean that the claim will be denied. The worker can challenge the controverted claim and present evidence to support their case. If the claim is ultimately denied, the worker may have the option to appeal the decision.