When a workers' compensation claim gets denied, it can be very disheartening. It means the claims administrator does not think the injury is covered by workers' compensation, but their word is not the final word-as mentioned in the last post, it is possible to appeal the decision.
As per the Department of Industrial Relations, there are 24 locations across the state to file a case objecting to the denial of the claim. Each office is basically a court where a judge, not a jury, decides the case. So, how does one get their appeal in front of the judge? Firstly, it is important to act quickly, as there are deadlines to file the necessary paperwork.
A person wishing to object to the denial of their claim must first file an application for adjudication of the claim at one of the offices responsible for the county where the injured party resides or where the injury took place. All parties must also be served with the papers. After this, the office sends a notice informing the injured that their case has been filed and they will receive a reference number to be used for all future correspondence. In order to get a hearing, the injured must file a declaration of readiness to proceed, after which the office will schedule a mandatory settlement conference.
The judge will first try to get the parties to reach a settlement, but, if this does not happen, then the parties should prepare themselves to present their papers and arguments to the judge. A date for the trial will be set and the trial will take place in front of another judge. A decision is given between 30 to 90 days after the trial. It is also possible to file for a reconsideration of the decision.
Ensuring that the process stays on track, no deadline is missed and accurate and relevant evidence is presented can be complicated, but is the essence of a case objecting to the denial of a workers' compensation claim. Getting help from an experienced attorney may be one way to ensure that one gets the compensation they rightfully deserve.