How to Appeal a Workers' Compensation Denial?

Receiving a denial letter from the insurance company denying your worker’s compensation claim can be frustrating and disheartening to say the least. This could possibly arrive at a time when you are neck-deep in financial trouble for having to pay medical bills that continue to pile up after your truck accident or any other situation you are tired of having to explain to people.

This is in addition to the physical pain you are already being made to suffer while your absence from work continues to cause further monetary woes. However, a denial does not imply end of the road as you can appeal against the worker’s comp denial and utilize a Colorado worker’s compensation lawyer (http://workers-compensation.usattorneys.com/colorado/).

Get in Touch with the Insurance Company

When your claim is denied it might be because the paperwork was not in order. If this is the reason given in the denial letter, then you must contact the company to rectify the errors in your paperwork. Following this, your claim is likely to be reconsidered and you will receive the compensation you rightly deserve.

Claims are often denied when the insurance company believes that the complainant isn’t eligible for the worker’s comp claim. This could happen if they determine that the accident did not happen in your workplace or you sustained the injuries after your working hours were over. Sometimes the insurance company refuses to clear your claim because they believe that the injuries or ailment was not workplace related but are the result of a pre-existing condition as well.

It would be judicious to meet with the representatives of the insurance company to reconsider your position. You can furnish some additional proof to the company in the form of workplace evidence such as work logs, witnesses, and other related documents along with medical records that can legitimize your claim.

File an Appeal

You can file an appeal on your own to the state worker’s compensation agency. But it advisable to seek help from a Colorado worker’s compensation attorney since the filing involves lot of paperwork. The deadline varies from one state to another. While some states the deadline is a year after the denial in other states you are required to file within a few weeks or a few months from the date on which you received the denial letter or intimation.

Moreover, the procedure too varies from state to state. In some states, a simple letter to the worker’s compensation board is enough for the appeal while in other states you are required to complete lengthy paperwork as well as attach all your medical and other records to file.

If you do not follow the procedures of appeal properly then your appeal is likely to be dismissed. Therefore, seek help from a legal representation before you file an appeal. In Colorado, you will have to submit an application for a hearing to the nearest Colorado Office of Administrative Courts.

The Centennial State may be pretty happy because of their football team but some people in Colorado are not so happy because they are in a truck accident worker's compensation dilemma. The good news is that finding legal help is not too difficult. It can be done through this legal virtual tool which is this website: http://workers-compensation.usattorneys.com/colorado/. Denver has a big game in 2 weeks but for anyone going through a worker's comp situation, that is their priority. And yes, even females drive trucks!

Mediation

Before the hearing many state laws mandate that you sit with the insurance company along with a neutral third party who will act as a mediator. You can attend the mediation without a legal representative but it is widely recommended that your legal counselor accompanies you since he would know how to manipulate the situation for your benefit and argue with the insurance company’s legal representative. In addition, your Colorado worker’s compensation lawyer can also help you with the financial negotiations.

Formal Hearing

If mediation fails, you will have to attend the formal hearing with your legal representative and present evidence before the worker’s compensation board that that the denial was wrong. Medical evidence, duty logs, and co-worker testimony can also be used as evidence to prove that you deserve compensation and that your claim is authentic.

However, if you fail to secure compensation at the hearing then you can appeal to the board a second time. You are not required to present all the evidence again but will have to explain why you think that the hearing officer’s decision was wrong.

If the denial is still not overturned then you can file a civil lawsuit against the insurance company and the worker’s compensation board with help from your Colorado worker’s compensation lawyer.