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Appealing a Denied Workers’ Comp Claim

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Appealing a Denied Workers’ Comp Claim

Appealing a Denied Workers’ Comp Claim

By Jan Hoen

In America, there are an estimated 2.8 people injured per every 100 employees. Often when you have been involved in a workplace accident and have suffered injuries, your workers’ compensation benefits are an incredible help. These benefits help you cover your financial responsibilities while you recover. 

Yet, some Virginia employees are denied workers’ compensation benefits which cause a variety of problems. If your workers’ compensation claim has been rejected, you can work with a Virginia workers’ compensation attorney to help you appeal your claim. At Hampton Injury Law PLC, we believe neither you nor your family should suffer due to a denied workers’ compensation claim. That’s why we work with you to show you how to appeal your workers’ compensation denial so that you can have access to your much-needed benefits. 

Reasons Why Your Workers’ Compensation Claim Was Denied

Before we can look at the steps you should take to appeal your denied workers’ compensation claim, it’s vital to understand why your claim was denied in the first place. In most cases, the reason your claim was refused will be listed on your denial letter. 

You Never Sought Medical Treatment

In Virginia, your workers’ compensation claim could have been denied because you never sought medical attention for your workplace injury. When you don’t seek medical care, an insurance company can claim you don’t require workers’ compensation benefits. That’s why it’s vital to seek medical care for your injuries as soon as you can. 

Your Claim Lacks Evidence

One of the biggest reasons that some workers’ compensation claims get denied is because an insurance company states a person did not provide enough evidence. In most instances, an insurance adjuster will claim that you did not provide them with sufficient evidence showing that your injury caused you to be unable to work. 

It can be challenging to find the appropriate evidence needed to prove that your injuries are preventing you from working. Fortunately, you can utilize a Virginia workers’ compensation attorney who can dig up the evidence for you. An attorney can attain eyewitness statements, video footage, and physician testimonies. 

You Filed A Claim Too Late

Another reason your workers’ compensation claim could have been denied is that you filed it too late. In Virginia, employees have two years within which they can file a claim. If you don’t file your claim within this timeframe, you will likely lose out on workers’ compensation benefits. 

The Steps You Need To Take To Appeal A Denied Workers’ Compensation Claim

If you have lost your claim at a workers’ compensation hearing, you are likely upset. It might seem like all the effort you went through to present your case at trial before a judge is for naught now that your claim has been denied. Fortunately, you can appeal the denial. Below are the legal steps you need to take when you need to appeal a denied workers’ compensation claim. 

File A Motion To Have Your Claim Reconsidered

The deputy commissioner in charge of your case has jurisdiction over it for thirty days after receiving the written denial. Should you disagree with the deputy commissioner’s decision, you have the right to file a motion to have your case reconsidered. 

The motion you file will ask the deputy commissioner to change their mind and issue an amended decision. Usually, a motion for reconsideration is only filed if you believe specific evidence was not seen or reviewed when a decision was made. Additionally, this type of motion is also filed if you think that the deputy commissioner made a factual error in evaluating your claim. 

Request A Review Of Your Claim By The Entire Workers’ Compensation Commission

When a motion to have your case reevaluated fails, you will need to file an appeal or case review with the workers’ compensation commission to have your claim accepted. You will have a maximum of 30 days to file an appeal with the compensation commission from the date of denial. 

Additionally, you will need to request a review in writing. You have to state the specific findings and conclusions that you believe were errors of the deputy commissioner in your letter. Moreover, you will need to send a copy of your written request to the opposing party. Usually, it will take a workers’ compensation commission up to six weeks to make a decision based on your written review request. 

File A Claims Appeal With The Court Of Appeals In Virginia

If you have requested a review and have still been denied, you have the right to appeal the commission’s final decision at the Court of Appeals in Virginia. You will need to file a written notice within 30 days of the commission’s decision with the clerk of the workers’ compensation commission and with the office of the Court of Appeals. 

After the Court of Appeals has relieved the appeals appendix, they will issue a briefing schedule. Additionally, you will need to file an opening brief within 40 days. You must consider utilizing an attorney as they will be familiar with the various rules of the Supreme Court of Virginia and know what documents to file and when to file them.

Once all the legal documentation has been received, the Court of Appeals will review the evidence and findings of the workers’ compensation commission. If the Court of Appeals finds the workers’ compensation decision to be credible, they will uphold the workers’ compensation commission’s decision. 

File A Petition For Appeal With The Supreme Court Of Virginia

Suppose you have not managed to appeal your workers’ compensation claim and get it accepted. In that case, the last step you can take if you have not managed to appeal your workers’ compensation claim and get it accepted is to file a petition for appeal with the Supreme Court of Virginia. However, you will need to get permission from the Virginia Supreme Court before you file a petition. 

Unfortunately, the Supreme Court of Virginia rarely grants reviews for workers’ compensation cases, but an additional briefing and oral argument will be required when they do. 

To Discuss Appealing your Workers’ Compensation Claim, Get In Contact With A Virginia Workers’ Compensation Attorney

The appeals process surrounding a workers’ compensation claim can be incredibly challenging to understand and navigate. That’s why it would be in your best interests to hire a Virginia workers’ compensation attorney. At Hampton Injury Law PLC, our workers’ compensation attorneys know the rules, regulations, and legal proceedings surrounding workers’ compensation appeals. We can help you through every step and try to get your denied workers’ compensation claim accepted. Get in contact with us for an obligation-free case evaluation. 

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