What Happens Next? Steps To Take After A Workers' Compensation Denial
Denial is not the end of the process. If you have been hurt in a work-related accident, you have rights to assert and moves to make. Rather than give up, take the below steps and reach out to a workers' compensation lawyer for additional help and support.
Carefully review the denial letter
When a claim has been denied, the denial always comes in the form of a letter from the workers' compensation insurer. The letter will include the reason or reasons for the claim denial. Be sure you understand any issues with the claim. In some cases, denials are based on minor issues with the claim form and may be rectified with a phone call to the insurer and an amended claim form.
Speak to a workers' compensation lawyer
This type of lawyer is experienced and knowledgeable in the intricacies of workers' compensation laws. The lawyer can examine your claim denial and advise you on what steps to take next. In many cases, you are entitled to file an appeal against any adverse action handed down by the insurer. Your state board of workers' compensation oversees disputed claims and dictates the process for filing an appeal. In most cases, the appeal includes reasons why you believe the initial denial is in error. Discuss your appeal chances with your workers' compensation attorney.
Provide more information
It's not uncommon for claimants to be asked to provide additional information to support their appeal claim. For example, you may need to gather and return things like witness statements, medical records, medical test results, doctors' letters, and more.
Participate in mediation
In many states, all parties are required to attend mediation meetings. This practice attempts to help the parties come to an agreement on a case. Professional mediators work with you and the insurer to resolve the case. Your workers' compensation lawyer will attend the mediation meeting with you in most cases. However, if you go alone, be sure not to agree to anything without the knowledge of your lawyer.
Attend the hearing
Hearings are not as formal as a courtroom situation but more formal than a conference room meeting. A judge doesn't preside over the hearing but a hearing officer working for your state's board of workers' compensation will head the hearing. The appeal hearing allows you to present evidence supporting your claim for benefits.
Although the road to benefits can be long, your workers' compensation lawyer will be there to help you at every turn. Contact a local workers' compensation attorney to learn more.