What to Know About the Workers’ Compensation Appeal Process
Guide to the Workers’ Compensation Appeal Process
Workers’ Compensation is something that is difficult for many people to navigate, and the workers’ comp appeals process can get even more complex. As a legal concept, it is one that relies heavily on intensive evidence and recording of workplace practices, and how reality may or may not coincide with those processes.
Being hurt at work can be devastating. When filing Workers’ Compensation claims, outright denials and a lack of findings cause stress for their claimants, something that, with the right legal representation, can be just a bump in the road.
We’re going to explore some of the concepts behind the Workers’ Compensation Appeals Process, with information that will be invaluable to you if you find yourself in this kind of legal morass. But, as always, it’s advised that you seek out only the best legal counsel to ensure you receive the compensation you are entitled to.
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Why Your Claim May Have Been Denied
It’s crucial to understand why your Workers’ Compensation claim was denied. For this, there are a number of reasons.
- Injury Was Not Reported on Time – This happens when you wait too long to report injuries to the workplace authority that handles workers’ compensation.
- Claim Was Not Filed on Time – You may have reported the injury on time, but filling out a workers’ compensation form is also required. There are typically deadlines for this, depending on your workplace or state.
- Employer Dispute – If your employer dispute your workers’ compensation claim, that will halt the process for review. You must find out exactly why they disputed the claim, so you can develop a strategy for your next steps.
- Injury Not Covered – State law mandates what kind of injuries can be claimed in a workers’ compensation claim. It’s important to understand the laws around what can be claimed for workers’ compensation. A qualified legal professional can help with this.
- No Medical Attention – Every workers’ compensation claim requires that you seek medical attention. If you did not seek medical attention, then it can be argued that the injury is not valid for workers’ compensation.
Steps for Filing an Appeal
If your workers’ compensation claim has been denied, you can’t lose hope. But, it’s important to understand why your claim was denied before going ahead with the appeals process.
The letter of denial you receive will make it clear why the claim was denied. This could be for a valid reason, such as those stated above, or for something as simple as a clerical error or typo.
When you receive your denial letter, first meet with your employer. This is important because there could be a simple and easy way to mend whatever problem arises from your workers’ compensation claim.
If you’ve determined that an appeal is needed for the claim, then it’s time to get down to business. You will draft your appeal letter, stating why you believe you’re entitled to workers’ compensation benefits. This letter is sent to a state body, often a state workers’ compensation review board.
Then, you will be summoned for a hearing, most likely with a judge who is a part of the state workers’ compensation branch. Here, you will present any relevant evidence, including medical records, statements of coverage in your employer’s workers’ compensation program, and more.
This appeal is heard, and claimants will often hear back within 30 days, though deadlines for filing and hearing back from appeals changes state to state.
If you’re facing a denial of workers’ compensation benefits in Connecticut, you need legal representation. Not only do our workers’ compensation attorneys know the system—they also have the attention to detail to ensure you make the right choices the first time, to get you the benefits you deserve.
Timothy C. Moynahan is the CEO and owner of Moynahan Partners, which offers business development consultancy, identifying strategic business partnerships and funding sources. He founded and heads the Moynahan Law Firm, Waterbury, Connecticut. He is a sought-after and successful trial lawyer, earning the Super Lawyer of New England and Connecticut awards from 2009 to 2012 and Best Criminal Defense Attorney accolade in 2013.