Were You Denied Workers’ Comp? Here’s What To Know

Workers Comp Lawyer

If you are reading this because your workers’ compensation claim was denied, remember that there still may be a chance that you can win an appeal. In fact, you may be in better standing by appealing a denial, than if you were approved the first time around. So as an injured worker who’s unsure what happens now, rest assured that this may not be the final verdict. However, you will seriously consider hiring a lawyer so they can give you a leg up on the situation.

Take a deep breath, and find your paperwork.

Upon finding out your claim was denied, it’s important to scale back the anger and disappointment by reaching for your workers’ compensation paperwork. Denials may be a result of misinterpretation, clerical error, or other technical issue. A resolution may be easily achievable with just a follow-up email or phone call to the insurance company. 

File for an appeal immediately after your initial denial.

The sooner you respond to an appeal, the better. If after speaking with the insurance company to no success, by filing an appeal you and them are now adversaries. In many cases, the insurance company will alter their verdict if a lawyer becomes involved. This is because many insurance companies take advantage of the fact that most people don’t understand their rights and what is fairly owed to them. 

Mediation or settlement conference may be scheduled.

A settlement conference, or otherwise referred to as mediation, entails an informal negotiation where the parties (ie. you and the insurance company) debate your side with support from a trained third party. This person is neutral to the situation and will try to encourage the conversation towards a solution. It is imperative to be professional, have a tidy appearance, and offer courtesy despite being upset.

If mediation fails, your lawyer can prepare you for an administrative hearing.

Mediation may fall through with no resolution. If that is the case, then your lawyer can work with you to prepare you for an administrative hearing. Here, your case will be heard in front of a workers’ compensation administrative judge, who will ultimately decide the case outcome. 

As Workers Compensation Lawyers from Hickey & Turim, S.C. have done for clients, sometimes you need a lawyer to guide you through the claim denial appeal process. Without a professional to offer insight, your chances of being approved the second time are significantly less. As an injured worker who was denied assistance, you must always put your health and finances first by taking action promptly. 


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