I always assumed that personal injury cases where pretty straight forward. After being in an accident, any financial losses that you suffered would be reimbursed by the liable party's insurance company. Unfortunately, things only work this way in a perfect world. In the real world, personal injury cases are extremely complex and getting the insurance company to pay a fair settlement requires the expertise of an experienced injury lawyer. Unfortunately, it took me several months to finally seek out the legal assistance I needed. As a result, I waited much longer than necessary to get the compensation I so desperately needed. During this time, I learned more about personal injury law than I ever thought I would. It is my hope that this blog will allow me to share that knowledge with you so that you can avoid making some of the same mistakes that I did.
If you have been injured on your job, have filed for workers' compensation and have had your claim denied, you have the right to appeal that claim. The letter that you receive in the mail should give you a good indication as to why the claim was denied, and what you can do to initiate an appeal. This article will give you an overview on appealing your workers' compensation claim.
Why Your Claim Was Denied
In order for you to take the next steps toward appealing your claim, you need to know exactly why your claim was denied. Some of the biggest reasons a claim is denied is because you failed to file the paperwork on time, or the claim did not provide all of the necessary information. Another common reason is that the employer disputes your claim, maybe because your employer feels the accident didn't happen at work.
Appealing Your Workers' Compensation Denial
The letter you received that advises of your denial may also provide instructions on how you can appeal the denial. The first step you should take is contacting the insurance carrier to discuss the denial. If the denial was only an oversight on failing to provide paperwork, the error could be rectified and your claim approved. But this is not a likely route to take if your claim was denied because of a mistake on your employer's or insurance company's part. If your employer refuses to do anything on their end to push the claim through, you'll have to start the formal appeals process.
The process for appealing a workers' compensation denial varies from state to state. Usually, the first level of appeal is at an administrative hearing before an appointed law judge. This hearing may be either through the state's workers' compensation board or your state's labor department. There are a few more levels of appeal beyond the administrative hearing, but again this varies from state to state.
You may be asked to present your medical evidence and other evidence that supports your claim that the injury sustained was work-related. You may have to bring in expert witnesses as well. Above everything else, make certain that your appeal is filed within the imposed time limits. For help filing your appeal and getting through the appeals process, it's best to retain an experienced workers' compensation lawyer. They can properly guide you and advise you based on your own particular situation. For more information, contact Robinson & Kole or a similar firm.Share