Appealing a Workers’ Compensation Decision in Lakewood
The workers’ compensation insurance program provides financial benefits to employees who have been injured on the job. Since injured individuals are often unable to work and generate income, the money they receive from worker’s compensation often supplements their usual income. After sustaining an injury, it is important for injured employees to file a claim with their employer immediately.
Unfortunately, filing a claim is not always enough, and it is possible for an insurance company to dispute your claim. If your workers’ compensation claim was denied, you may be able to file an appeal and reverse the decision. By law, insurance companies must allow you to appeal their decision if you do not agree.
If you have questions about appealing a workers’ compensation decision in Lakewood, be sure to get in touch with a seasoned attorney for assistance.
Why Do Insurance Companies Deny Workers’ Compensation Claims?
Insurance companies deny benefits for a variety of reasons, and while some of them are valid, many are not. Insurance companies often deny workers’ compensation benefits for the following reasons:
- They believe the injury in question did not occur on the job
- The injury was the result of a preexisting medical condition
- There is a dispute as to when or where the injury occurred
- A medical professional believes the employee was not disabled as a result of their injury
- The insurance company does not believe the employee is injured at all
Claims can also be denied when an employee fails to file a claim in a timely manner or submit the necessary documents. If a claim is denied for any reason above, the claimant is allowed to file an appeal.
Process of Filing an Appeal
If a claimant elects to file an appeal, they must follow the directions exactly. Any mistake can jeopardize a person’s benefits and result in a second denial. Before proceeding, it is recommended to contact an insurer directly and find out why the appeal was denied. If the insurance company refuses to reconsider its initial decision, the claimant must file an appeal within the allotted timeline.
When filing an appeal, injured claimants may need to submit additional documents to prove they are truly injured and unable to work. They may also need to obtain statements from witnesses. After receiving an appeal, insurance companies are legally obliged to issue a decision within a reasonable amount of time.
Requesting a Hearing After a Second Denial
If an appeal is denied a second time, the claimant has the right to request a legal hearing. This hearing occurs in a formal setting and is presided over by a court official who has the right to make a ruling. During a hearing, both the insurance company and the claimant have the right to submit supporting evidence, call and interview witnesses, and speak on their behalf. If the hearing official believes the claimant is in the right, the claimant would receive their benefits and any benefits they are owed from previous months.
If the court official rules in favor of the insurer, the claimant may be denied benefits again. To prevent this from occurring, injured employees should work with a lawyer with experience in appealing a workers’ compensation decision in Lakewood.
Learn More About Appealing a Workers’ Comp Decision in Lakewood
The thought of filing an appeal or attending a formal hearing can be intimidating to many people, and for good reason. Attending a hearing without reliable legal representation can be a mistake, especially considering the insurance company would have its own attorneys. With the right representation, injured employees may be able to obtain their benefits and the medical care they need.
Learn more about appealing a workers’ compensation decision in Lakewood today.
