Denied Claims: Steps in the Appeals ProcessPosted July 7, 2014
If your workers’ compensation insurance denied your claim after a work-related injury, never take “no” for an answer; make sure you go through the steps in the appeals process. The denial may be a simple mistake on your part, or your doctor may have failed to properly delineate why and how your injury will require you to miss work in order to recover from your injuries.
Some other reasons for a workers’ compensation injury insurance claim to be denied include:
- Your employer believes your injury resulted from a pre-existing condition
- Your employer disagrees with how, and/or where your injury occurred
- Your physician does not believe your injury should result in missed work
- You failed to fill out the proper paperwork
Steps in the Appeals Process for Denied Claims Include:
- You may request to have your case heard by a judge
- You or your lawyer must file a Motion To Set For Trial (Form 9)
- Employees and their employers must submit permission in writing for the Workers’ Compensation Court of Existing Claims Administrator, the Attorney General, and the District Attorney to review all the records concerning the workers’ compensation claim for injuries and this may include medical records of the injured claimant.
- A trial consists of a non-jury hearing before a judge where testimony, all facts, and medical documentation are presented.
- The judge will determine if any benefits are awarded based upon the evidence presented during the non-jury trial.
- The claimant may also request a mediation hearing to settle the dispute. Any settlement agreements must also receive court approval.
Oklahoma Injury Claims
While it is not mandatory to have an attorney represent you in the appeals process, our attorneys have a highly respected rate of success in advocating and winning these cases for their clients. We are committed to our clients’ rights for fair and just compensation. Contact our attorneys for a free consultation today.