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How to Appeal a Denied Workers’ Compensation Claim

When you file a claim for workers’ compensation, it can be devastating to learn that your claim has been denied. However, it is important to understand the reasons for the denial so that you can appeal the decision.


If you believe your claim has been unfairly denied, you can file an appeal with the help of a skilled workers’ compensation attorney.


How to Appeal 


Although an appeal process can vary depending on the state and the specific circumstances of the case, here are some general steps you can take to do so:


1. Review the reason for the rejection. Before anything, you must fully understand the reason why your claim was rejected. Typically, your employee’s insurance company produces a letter explaining the reasons for the denial. Some common reasons for denial include missed deadlines, insufficient medical evidence of the injury or illness, or the injury or illness is not work related.


2. Gather as much additional evidence as possible. If you believe your claim was denied in error, you may need to gather additional evidence to support your case. This may include medical records, witness statements, or other documentation that can support you.


3. File an appeal. Once you have determined the reason for the denial and gathered additional evidence, you can file an appeal. It is important to consult with an attorney who specializes in workers’ compensation law to understand your options and next steps.


4. Attend the hearing. After you file an appeal, you will usually be scheduled for a hearing. In this, you will have the opportunity to present your case and all the documents that you have gathered.


5. Wait for a decision. Once the hearing is over, you will have to wait for the decision on your appeal. The time it takes to receive a decision can vary, but you should receive a decision in writing that explains the outcome of the appeal.


If your appeal is also denied, you may be able to file a further appeal or take legal action.


To ensure that your appeal has the best chance of success, consider retaining an experienced workers’ compensation attorney who can help guide you through the appeal process, as well as represent you in court if necessary.


At Grupo Vía Dorada we can help you. Call us today and schedule a consultation!