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Do You Need to Appeal a Workers’ Comp Denial?

Posted on June 21, 2013 to

A Washington, D.C., Maryland and Virginia Injury Attorney Can Help

Workers’ compensation has been used in America since before the Civil War. Whether it is disability benefits, compensation for medical treatment, vocational rehabilitation or survivor benefits, workers’ comp is an important tool for ensuring that the workers of Virginia, Washington, D.C. and Maryland have what they need to survive when they are injured on the job.

Although many workers’ comp claims are handled without issue, sometimes a worker may find their claim denied, despite it being legitimate.

Reasons for a Workers’ Comp Claim Denial

Claims can be denied for several different reasons. Common causes for denial include:

  • The injury allegedly did not occur while you were working
  • The injury was allegedly caused by a preexisting condition
  • The insurance company mistakenly found you were not disabled due to the injury
  • Required documents were missing
  • The claims administrator doubts you were actually injured in the manner described

Insurance companies do not always deny claims for legitimate reasons. Furthermore, the reasons they cite for denying the claim may not have been relevant to the claim. If your claim has been denied, you have the option of appealing with your state’s labor board.

Appealing a Workers’ Comp Claim Denial

First and foremost, if your claim has been denied, it would be wise to enlist the assistance of a Washington, D.C., Virginia and Maryland injury attorney. Although you may represent yourself in the proceedings, having proper legal counsel on your side will increase the likelihood of a successful appeal. Plus, it is almost guaranteed that your employer or the claims adjuster will have their own legal representation at the appeal hearing.

Each state has its own regulatory body that oversees workers’ comp claims and appeals. In Maryland and Virginia, appeals are handled by the state’s respective Workers’ Compensation Commission, whereas the District of Columbia’s Department of Employment Services oversees appeals in Washington.

The appeals process begins with a request for a hearing. This request is typically filed by mail but can also be done in person at a representative office of the department that oversees workers’ comp in the state. Hearings are typically scheduled to take place a few months after the request is filed.

At the hearing, a judge will review your case as well as any arguments or statements your employer would like to make about the claim. If the case is ruled in your favor, then you will win the compensation that you originally claimed from your employer.

If Your Workers’ Comp Claim Was Denied, Help is Available

If you believe your worker’s comp claim was unjustly denied, help is available from a Virginia, Maryland and Washington, D.C. injury attorney. Contact our office today to have your situation professionally reviewed. Through legal action, you may be able to win the workers’ compensation payments that you are entitled to by law.