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Appealing your workers’ compensation denial

On Behalf of | Jun 6, 2023 | workers' compensation |

Finding out your workers’ compensation claim has been denied can be a devastating blow. You were already likely struggling after a work-related injury or illness, as you try to survive without your income and pay for your medical costs.

Why claims are denied

There are various reasons why your workers’ compensation claim may be denied. Your injury or illness might not be deemed work related or your employer could claim even claim your injury was intentional.

Sometimes claims are denied for relatively minor reasons, such as a clerical error on the forms that were submitted, or a missed deadline.

Feeling confused and overwhelmed after your denial is common, but it is important to know that you have options, like appealing your denial.

Pay attention to deadlines

Once you receive your denial letter, you have 30 days to appeal the decision. There are various requirements involved with filing an appeal, and it is crucial that they are met, since missing one or submitting your appeal petition incorrectly could cause your appeal to be dismissed.

After you file your appeal, your employer will have an opportunity to respond to your appeal petition. Once their response is filed, you can request a hearing before a workers’ compensation commissioner.

When you submit your request for a hearing, you must include a list of issues that you believe were incorrectly decided. For example, the issue might be that it was determined your injury was not work-related.

What happens at the hearing?

At your hearing, you can present testimony and evidence in support of your claim. Your employer will also have an opportunity to argue their side and present evidence.

Since the appeal process involves many steps and requirements, it might help to work with a professional who can help you make sure everything is done properly.

When your hearing date arrives, having someone on your side to advocate for you can make a huge difference in the outcome.

 

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