It is no secret that the insurance companies that administer workers’ compensation policies will find any possible reason to deny a claim. For example, an insurance company may argue that your injury did not result from your job duties or that your injury is not severe enough to justify benefits. Receiving a denial is especially devastating when you are unable to return to your job because of an occupational injury or disease.
Thankfully, you have the right to appeal a workers’ compensation denial. Typically, the first step involves having a hearing before an Administrative Judge. However, you can demand a full judicial appeal if you are not awarded appropriate benefits. A Colorado Springs workers’ compensation appeals lawyer is ready to help injured and ill employees pursue the benefits they deserve. Contact a knowledgeable workers’ compensation attorney today to learn more.
Why Are Workers’ Comp Claims Denied?
Knowing the reason behind a denial is vital to understand the appeal process. In some cases, an insurance company will deny a claim because the employee did not prove that the injury or disease resulted from their job duties or that they cannot work because of their injury.
Disagreements can also arise concerning the extent of the worker’s injury. The treating doctors should provide their opinion on how the injury limits or destroys a person’s ability to do their job. When the insurance company refuses to accept the doctor’s opinion, it may result in a denial. A Colorado Springs workers’ compensation appeals attorney could help explore the reasons for the denial and identify any flaws in the insurance company’s argument.
How to Appeal a Workers’ Compensation Decision
Ideally, a worker can get proper benefits without asking the State to intervene. However, the State retains the authority to adjudicate disputes between workers and insurance companies. That said, the employee can petition the Department of Labor and Employment to hold a hearing to resolve the dispute.
If the outcome of the hearing does not favor the employee, they have the right to request a rehearing, but they must be able to prove that the original hearing officer made an error that damaged their case. Examples include not correctly applying the rules of the hearing or excluding relevant evidence for improper reasons.
A knowledgeable lawyer is ready to explain further the process of workers’ compensation appeals in Colorado Springs and take the lead in representing the interests of the injured employee.
Contact a Workers’ Compensation Appeals Attorney in Colorado Springs Today
Pursuing a claim for workers’ compensation benefits is a legal process. While most cases end with a fair payment plan without needing to go to court or file a request for a hearing, denials are common.
You have the right to a hearing or an appeal after receiving a denial. The denial of your claim may be due to insufficient medical evidence or inability to connect the injury to your job duties. A Colorado Springs workers’ compensation appeals lawyer could identify the reason for your claim’s denial, obtain more information about the incident that led to your diagnosis, and file appeals on your behalf to seek a fair result. Reach out to a lawyer immediately to get started.