What should I do if my Worker’s Compensation Claim is denied?

There will only be a short time to appeal

If your worker’s compensation is denied by the Worker’s Compensation Insurance Company, you should immediately call my office at (617) 523-2929 and make an appointment. There are no cost or expenses to you for hiring me as your Worker’s Compensation attorney.

Why Was Your Claim Denied?

As a worker’s compensation attorney, my first goal will be to understand your case, and to learn about why your benefits claim ws denied. In this respect, it is important to be able to apply the law with respect to the particular facts of your case. Because there will be a built-in incentive for the worker’s compensation insurance company to deny the benefits, and appeal is needs to be based upon why your claim must be paid in under the law.

I will also want to know what benefits may have been denied. In some cases, the benefits may be limited to payments that may be due. In other cases, benefits may include other aspects, such as a continuing right to receive medical and rehabilitation treatment. In any case, it’s important to receive the full benefits to which you are entitled, and not to inadvertently lose benefits.

After I meet with you, I will contact the Worker’s Compensation Insurance Company to see if they are willing to begin paying you weekly benefits. Based upon our conference, I can explain why such benefits are due. I will immediately file a claim with the Department of Industrial Accidents and we will soon receive a conciliation date.

The Conciliation

The conciliation is an informal meeting with a representative from the Department of Industrial Accidents, the Worker’s Compensation Insurance Company and myself. Many times at this conciliation, I am able to reach an agreement for your weekly payments to begin. If other benefits are in question, I will also seek to make sure that these other benefits are provided as well.

If the Worker’s Compensation Insurance Company continues to deny your claim, your claim will be forwarded and assigned to a Judge at the Department of Industrial Accidents, and we will receive a notice of a Conference date.

The Conference and Conference Order

The Conference is held at the Department of Industrial Accidents before a Judge at the court. Also an attendance will be an attorney from the Worker’s Compensation Insurance Company, me, and you as my client.

At the conference, I will present all of your medical records and make an oral argument of why the Judge should order the Insurance Company to begin paying you weekly benefits and your medical bills. The attorney from the Worker’s Compensation Insurance Company will make an oral argument against the Judge awarding you weekly payments and medical benefits. After hearing the oral arguments and reviewing all the medical records, the Judge will issue a Conference Order indicating the decision on your weekly benefits and medical payments.

In a great majority of my cases, I am able to persuade the Judge to award my client weekly benefits and payment of medical bills. If you or the attorney from the Worker’s Compensation Insurance Company are unhappy with the Judge’s Conference Order, an appeal can be filed by either or both sides.

What Happens When an Appeal is Filed?

In an appeal is filed, a doctor will be assigned to your case from the Department of Industrial Accidents and the doctor is called the Impartial Physician.

Soon, we will receive a notice for the date you will be examine by the impartial physician and this doctor will also review all of the medical records related to your injury at work.

The Impartial Physician will then generate a medical report and give an opinion on whether the injury is related to work activities, the extent of disability, and the need for treatment.

Once the impartial physician report is received by the parties, the Department of Industrial Accidents will issue a notice of the date and time of the next court date and this court proceeding is called a Hearing.

The Appellate Hearing

At the Hearing, all parties must again be present and the Judge will hear testimony from the injured worker and any witness of the injury or witnesses from the employer.

Typically, during this time, a great many of the Worker’s Compensation cases settle prior to the Heating beginning.

If the parties are unable to settle the case, and the Judge will hear the witness testimony at the hearing. The Judge will then issue a formal and final written decision outlining thoughts on disability, the need for treatment, and whether the weekly Worker’s Compensation checks should continue or stop.

Call Me to Find Out How I Can Help with Your Appeal

It is very important that you keep in mind there are no up-front expenses charged to you for hiring me as your Worker’s Compensation Attorney, and you can do this by calling my office at (617) 523-2929, through my website at www.frawleylaw.com, or emailing me at [email protected].