What defines a "controverted claim" in workers' compensation?

A "controverted claim" in workers' compensation refers to a situation where there is a dispute regarding the claim. This typically occurs when the employer or the insurance carrier challenges or denies the validity of the claim filed by the employee, often due to questions about the nature of the injury, the causality of the incident, or the employee's eligibility for benefits.

Controverted claims are significant because they may require further investigation, legal proceedings, or mediation to reach a resolution. This distinction is crucial as it affects the process that follows and the entitlements available to the injured worker. Understanding the nature of controverted claims is vital for both employees and employers to navigate the complexities of workers' compensation effectively.

The other options do not accurately define a controverted claim: an approved claim indicates acceptance, an automatically resolved claim suggests a straightforward processing without dispute, and a claim with no documentation would typically be rejected rather than being a matter of contention.