What To Do if Workers’ Comp Isn’t Responding
When your workers’ compensation claim disappears into a black hole of silence, this can be an extremely stressful time for you. Without income, you have plenty of worries about your finances and health.
What should you do if workers’ comp isn’t responding? Sadly, delayed responses from workers’ comp insurers are not uncommon. Whether it’s stalling, red tape, or outright neglect, you deserve answers.
If you’ve filed a claim and have not heard back, here’s how to take back control and start moving forward.
Why Workers’ Comp Claims Get Delayed
Before taking steps to resolve the situation, you need to know why the delay may be happening.
Insurers may claim they’re still reviewing your file, but there could be more going on behind the scenes, like a pending claim denial. Some common reasons include:
- An active investigation into your claim: If the insurer has questions about how the injury occurred or whether it is work-related, they may take extra time to collect evidence or request additional documentation.
- Administrative backlog: Workers’ comp insurers often handle a high volume of claims. Sometimes, your file gets lost in the shuffle.
- Missing or incomplete paperwork: If your claim lacks a doctor’s report or other required forms, the insurer may pause processing until everything is received. This can happen all without notification.
No matter the reason, you shouldn’t be left in limbo.
Start Documenting Now
While waiting, you need to start building a solid paper trail. Documentation not only keeps you organized, but you might need it as evidence later. You will want to track every detail related to your case, including:
- Dates and times of all phone calls with the insurance company
- Names of representatives or adjusters you have spoken to
- Copies of letters or emails sent and received
- Medical appointments, diagnoses, and treatment plans
- Days missed from work and any lost wages
- Out-of-pocket expenses related to your injury
All this information can help you if you need to file a formal complaint or take legal action.
Follow Up Regularly
Reaching out on a regular basis can show the insurer that you are not going away quietly. How you follow up matters just as much as how often you follow up. When you call, remain calm and professional. You will want to reference past communications and always ask for a timeline for the next steps.
Some tips include:
- Call during business hours and ask to speak with the same claims adjuster to create continuity.
- After each call, send a follow-up email summarizing what was discussed.
- Request updates in writing whenever possible.
- Keep a communication log noting who you spoke with, what was said, and when to expect a response.
- Remember that persistence is key. You don’t want to let frustration undermine your credibility.
Understanding the Legal Deadlines
Each state sets deadlines that insurers must follow when processing workers’ compensation claims.
For example, many states require the insurer to accept or deny a claim within 14 to 30 days of submission. If those deadlines have passed and you still have not received a response, the insurance company may be violating state law.
You can check your state’s workers’ compensation board website or call their office to find out exactly what deadlines apply in your case. Knowing your rights helps you push back with confidence.
File a Formal Complaint
If you have waited longer than the law allows, you may need to escalate the issue. You need to file a formal complaint with your state’s workers’ compensation board or commission. This step often forces insurers to act, especially when they risk penalties or regulatory action for non-compliance.
The board may:
- Open an investigation into your claim
- Impose fines on the insurer
- Order the insurer to provide a formal response
- Assist with scheduling a hearing or mediation
In many situations, a little formal pressure can break the logjam and push your claim forward.
Bring in Legal Help
However, the most powerful move you can make when facing radio silence from an insurer is to consult with an experienced workers’ compensation lawyer. Insurers respond much more quickly and seriously when they know you have legal representation.
A workers’ comp attorney can:
- Demand timely action on your behalf
- File legal motions to move your case forward
- Make sure all deadlines and requirements are met
- Represent you at hearings or before an administrative law judge
- Help you access benefits such as temporary disability payments
- Handle appeals if your claim is denied
These attorneys understand the workers’ compensation system and know exactly what buttons to push when insurers are stalling.
Stay Focused on Your Recovery
While the legal and insurance issues play out, your health should remain the priority. You want to continue seeing your doctor, following your treatment plan, and attending all scheduled appointments.
Not only does this support your recovery, but it also reinforces the legitimacy of your claim through consistent medical documentation. If financial pressure is mounting, ask your attorney whether you qualify for temporary disability or other support programs. You may be able to get some help while your case is pending.
Silence from the insurance company can feel like a dead end, but it isn’t. You have options, and you have rights. However, the most important thing is not to wait for answers. You need to take action.
If workers’ comp is dragging their feet, you don’t want to wait another day. At Work Injury Advisor, we have the resources to help you get the answers for your claim.
