Informal Vs. Formal Worker's Compensation Hearings
A denied worker's compensation claim can be a frustrating experience. You need compensation for your injuries as soon as possible, but the process of having a denied claim appealed can be very challenging. The good news is that you have the right to appeal a denied claim. However, you will need to file an appeal within a time frame that varies from state-to-state, so it is important to get the process started soon.
Correcting Any Mistakes
Contact the insurance provider and inquire about why the claim was denied. There are some cases where the denied worker's compensation claim can be easily appealed. For example, you may have forgotten to submit a document or submitted a form with a field that you forgot to fill out. By completing this form, your claim may be approved. If your claim is not approved, it is recommended that you consult with a worker's compensation attorney to help you with both the informal and formal claim appeal process.
Other Reasons For Claim Denials
There are other reasons that your claim might be denied. For instance, the insurance provider may believe that your injury was caused by something else and that the work-related injuries were minor. If you can supply evidence supporting that the work-related injuries were the major factor in your injury, you may have your worker's compensation denial overturned.
When disputing a worker's compensation denial, you should begin with an informal claim. You must simply submit an application for an informal hearing for your state worker's compensation division. You will then be informed on where the hearing will take place. This is a form of mediation that allows you to avoid involving the courts. After hearing both sides, a judge will offer a recommendation. However, this recommendation is non-binding. However, there is a good chance that the insurance provider will consider the recommendation to avoid a formal claim.
If the informal claim fails, the next step is to file a formal claim. After you have submitted a claim, you will have a formal hearing scheduled in a few months. The hearing is similar to a formal court case in which you submit testimony and call upon witnesses. Given that it is difficult for a layman to effectively navigate the legal system, it is in your best interest to get in contact with a worker's compensation attorney like those at John V. Boshardy & Associates, P.C. who can assist you in this process.