A workers’ compensation decision by a judge is not a denial; a person can lose on some issues but not all issues. If they are asked why a workers’ compensation judge would not decide in the injured worker’s favor, it is because if the other side made a better legal argument or the law was more on their side or against it on that specific issue.
However, appealing a Denver workers’ compensation decision is an option for those who are unhappy with the outcome of their claim. If you are unhappy with the outcome of your workers’ compensation claim, consult a competent workers’ compensation attorney that can advocate for you.
When Should Someone Consider Appealing a Decision?
At that first level, if an administrative law judge gives an unfavorable opinion in a person’s case then they definitely do have the right to appeal it to the Industrial Claims Appeals Office. That is the next level appellate court in workers’ compensation. However, that is a personal decision and an individual should consult an attorney to see whether appealing a Denver workers’ compensation decision is viable.
The attorney cannot just argue/appeal the decision by saying they do not agree. They have to meet the legal standard or burden of proof showing that this administrative law judge made a clear error if there was a real issue because they give a lot of deference to those administrative law judges, they know what they are doing. The appeals judges are there to consider whether the ALJ made a mistake. It is not a mistake because a person disagrees with their opinion; it has to be something that was done wrong.
Process of an Appeal
When an administrative law judge submits their opinion, their order, they will give instructions, and a person has a certain number of days to start their appeal process. In that process, they are filing what is called a petition to review. Once a person files that petition to review, the Industrial Claims Appeal Office will give a briefing schedule and then each party has to submit their brief in support of or in opposition to the petition to review and explain why or why not they should be appealed, and then it is another panel of judges who decide on the appeal. They are referred to as the Industrial Claim Appeals Office’s panel.
Components That Ensure the Success of a Claim
In order for a workers’ compensation claim to be found compensable, a claimant must prove by a preponderance of the evidence – that is the standard or the burden of proof – that is more likely than not or essentially 51% or more likely, they sustained an injury or an occupational disease arising out of and in the course and scope of the employment.
That means that the injured worker has the burden to establish causation, or a relationship between the injury or condition and the work, their job duties. It is hard to break into elements A, B, C, but it boils down to that causal relationship. A person has to prove, that they were an employee that was injured on the clock while doing a task that was a part of their job.
Circumstances Where an Appeal Would Be Denied
If an ALJ issues an order for the first time on litigated issues, there are no circumstance under which the injured worker cannot appeal. They always have the opportunity. When a workers’ compensation carrier denies the claim, it is not called an appeal. They can always challenge the denial, and challenging it is basically filing an application for hearing and litigating the issues.
A person files an application for hearing if their claim is denied by the workers’ compensation carrier, then they go to a hearing. If it is a hearing on compensability, if the judge decides that it is not a compensable claim, the person’s option is to appeal the decision to the Industrial Claim Appeals Office and they make a decision. If the plaintiff does not agree with that decision then they can appeal the decision to the Colorado Court of Appeals. If that decision is unfavorable for whatever reason, a person can appeal that to the Supreme Court of Colorado.
Role of a Denver Workers’ Compensation Lawyer
Not only can a workers’ compensation lawyer determine whether appealing a Denver workers’ compensation decision is the right for you, they can also help you navigate the appeal process. Your attorney can help by filing the necessary documents for that petition to review, as well as preparing a brief to support it with legal arguments. If you want to appeal a workers’ compensation decision, consult a qualified workers’ compensation lawyer that could work tirelessly to achieve a positive outcome for you.