Do you need help challenging a denied workers’ compensation claim in Roanoke?
If you were injured while working, you likely began the workers’ compensation claim process. You might expect to have your costs covered and to start receiving wage benefits. But what if you are denied? This is known as a disputed claim, and you will need to take steps to contest the decision, including requesting a hearing before the Virginia Workers’ Compensation Commission. After a hearing, if the Workers’ Comp Commission denies you benefits, you have the option to appeal their decision in order to obtain benefits.
To speak with a lawyer about appealing a workers’ comp denial, contact Lugar Injury Law at (540) 384-0348 or through our online form. Our experienced Roanoke workers’ compensation lawyers are here to fight for you to receive the help you need following a work accident.
Contesting a Workers Comp Decision in Roanoke
If you file a workers’ comp claim and your employer or the insurance company denies that claim, then you may have to have a hearing at the Workers Compensation Commission. This involves requesting a hearing before the Virginia Workers’ Comp Commission. At the hearing, your attorney will present evidence that your claim should be accepted and paid by your employer and their insurance company.
There are times when your employer may accept the medical portion of your claim, but deny wage loss or other portions. In this situation, you may have to try the case in part, but not all, to obtain an award for the claim. An attorney can help you gather the information necessary to prove that you deserve full benefits.
There are also instances where an employer may pay claims in order to make you think you have been approved. Once deadlines pass, the employer will try to deny the claim. There are opportunities now to contest or appeal the denied claim.
It is especially important to take action when you receive documents from the Virginia Workers’ Compensation Commission. An attorney can assist you in figuring out what benefits you should claim and what doctors you can or cannot see.
Workers Compensation claims are challenging. They typically evolve while the claim progresses. Both parties are often involved in the treatment or watching the treatment. It is helpful to have an attorney on your side to understand and avoid the pitfalls. We address medical notes that do not explain the connection between the injury and the accident or lack the detail your claim needs.
Workers Comp Mediation in Roanoke
When a claim is contested, you can opt to resolve your case through mediation. This is an out-of-court process. You and your employer discuss your claim in the presence of a neutral third party. If you wish to go through mediation and not rely on a hearing to resolve your claim, our workers’ comp attorneys at Lugar Injury Law can guide you through this process.
However, going through mediation does not guarantee a resolution. If you and your employer cannot come to a fair agreement regarding your workers’ comp claim, then you will still need to participate in a hearing.
The Steps to Appeal a Workers Comp Denial in Roanoke
The appeal process must begin quickly after the Deputy Commissioner’s initial decision on your case. If you receive a decision that you disagree with, talk with an attorney. You need to follow the administrative process. Otherwise, your right to appeal could be denied.
You have 30 days to file a Request for Reconsideration or an appeal. Whether the request is appropriate depends on the facts of your claim. It may be appropriate if you believe the judge did not review certain evidence or made a factual error. The reconsideration request goes to the Deputy Commissioner directly, who can then review your case and either maintain their position or alter their decision.
You also can appeal to the full Commission within 30 days of the judge issuing the decision. That is regardless of whether you filed a Request for Reconsideration. A Request for Review argues why you believe the previous decision was made in error. You cannot simply argue that you disagree with the decision. You need to point to specific errors in the previous decision. It is best to work with an experienced lawyer.
When you are appealing, they will review the hearing transcript, any evidence, and written statements and briefs from you and your employer. Your written statement should be comprehensive, which is why we recommend having your workers’ compensation attorney draft it.
Usually, the full Commission makes a decision after reviewing the hearing transcript, previously-admitted evidence, and written statements. However, there are circumstances under which you or the other party can request oral arguments.
You May Appeal the Full Commission’s Decision
If the full Commission reviews your claim, you may be entitled to appeal to the Court of Appeals of Virginia. At this point, you transition away from the administrative process and into the civil court system. The Court of Appeals of Virginia will follow different rules than the Commission. It is essential that you work with an experienced workers’ comp lawyer.
If you disagree with the appeals court’s decision, you may be entitled to file an appeal to the Supreme Court of Virginia within 30 days.
When Should You Appeal or Contest Your Claim?
There are strict deadlines for when you must submit a claim. It is essential to work with an attorney to meet all of these deadlines. In fact, your employer may try to get you to miss these deadlines in order to avoid paying a significant claim.
Do You Have Questions About Appealing a Workers’ Comp Denial?
At Lugar Injury Law, we will fight for you to receive appropriate benefits. Whether you are at the beginning of the workers’ comp claim process, or you believe you need to file a workers’ compensation appeal, we can help.
We will make sure your appeal or contested claim for benefits is filed in a timely manner. We can present a fact-based argument for why there should be a different result. We will carefully analyze the facts of your case. We will develop the strongest argument possible for why you should receive workers’ comp benefits.