Your Workers' Compensation Claim May Have Been Denied,
But You Are Not Out of Options.
Workers’ Compensation claims can be denied for a number of reasons. The employer or insurance company can deny
that an accident occurred or that one occurred but the employee wasn’t hurt. If you’ve received a Notice of Workers’ Compensation
Denial, you must file a claim petition for benefits under the Workers’ Compensation Act. Once the claim petition is filed, the Bureau
of Workers’ Compensation will assign a Workers’ Compensation judge to hear your case.
Know What to Expect During Your Claim
If you’ve received a Notice of Workers’ Compensation Denial, you have three years from the date of your work injury to file a claim petition. There are some instances where the three-year statute of limitations can be extended.
Once litigation begins, your employer’s Workers’ Compensation insurance company will hire a lawyer to fight against your right to benefits. During the litigation process, the defense attorney will make several recommendations to the insurance company, such as surveillance or settlement.
As a former Workers’ Compensation defense attorney, I advise you to take any attorney’s involvement in your Workers’ Compensation case seriously. Defense attorneys are trained to twist facts, create alternate causes for your injuries, and generally assist Workers’ Compensation insurance companies in denying cases.
Build a Strong Case
In order to win a denied claim, the following evidence is needed:
Factual Evidence: This is testimony from you and other witnesses
(if necessary) to document that you had an accident while working
that caused you physical injury; and
Medical Evidence: This is testimony from your doctor(s) confirming
that your injuries are related to the accident that you testified about
and how it affects your ability to work.
During the litigation of a Workers’ Compensation claim petition, your
medical bills will likely be denied by the Workers’ Compensation
insurance carrier.
You may have to turn to your own health insurance
for payment of medical bills during this time. Attorney Barbara Welton
will work with your health insurance company to make sure your medical
bills are paid during this time.
Keep in Mind
Certain benefits can reduce the payment of Workers’ Compensation benefits:
• Unemployment Compensation;
• Short Term Disability;
• Long Term Disability; and
• Social Security Retirement.
Any award of Workers’ Compensation lost wages can be reduced by the benefits received.
It is possible that you may return to work during the litigation of a Workers’ Compensation claim petition. If that occurs, the case can still go to a decision, but the amount of Workers’ Compensation benefits awarded may decrease.
