What can you do if your workers’ compensation claim is denied?

by | Jun 16, 2021 | Workers' Compensation |

Receiving a workers’ compensation claim denial can be disheartening. Not only do you face the challenges of recovering from your injury, but you may not be able to receive the support that you and your family need to move forward. However, a denied claim is not the end for injured workers, and there are steps you can take to move your claim forward and pursue the compensation you need.

What steps can a worker take to appeal a denied claim?

If you cannot resolve your denied claim with the insurance company, you can request an informal hearing. This hearing allows you to speak with a Workers’ Compensation Commissioner to review your claim and make recommendations to resolve the issue. During the informal hearing, you may also introduce evidence to support that claim. This additional evidence can be particularly beneficial if the denial resulted from missing information in your application or because the insurance company denied the severity or cause of your injuries.

If an informal hearing does not resolve the dispute, a formal hearing may take place. Similar to court proceedings, a formal hearing allows you to present evidence and witness testimony before a Workers’ Compensation Commissioner.

If the Commissioner does not award you benefits in their finding, you have 20 days to request a Compensation Review Board appeal. During this appeal, three representatives of the Workers’ Compensation Commission will review the record of the formal hearing.

Because the appeals process can be complex, you may want to speak to an experienced workers’ compensation attorney. They can review your denial, guide you through the appeals process, and help your claim the greatest possible chance for success.