What To Do When Your Workers’ Compensation Claim is Denied

The road to receiving workers’ compensation can be rough and long, and if you fail to take the right steps, your work comp claim could very easily be denied. It could be because you failed to report the injury in the correct timeframe or the insurance company chalking it up as a pre-existing condition.

The decision on whether your work comp claim is approved or denied in the first place starts with your evidentiary hearing. During this, you will appear in front of an administrative law judge. This proceeds like a non-jury civil trial. You and your lawyer have what is referred to as ‘burden of proof,’ meaning you must provide evidence to prove that you need the compensation you are asking for. The administrative law judge will review the evidence and argument that both parties bring and either approves or denies the claim.

After the ruling is considered final, both parties have the opportunity to file an appeal.

So long as you file your claim within 20 days of the administrative law judge’s decision, you have the opportunity to appeal. It is strongly recommended that you hire a workers’ compensation lawyer, if you have not already. The appeals process is best handled by someone with years of experience with appellate court.

First Appeal: Labor and Industrial Relations Commission

If you are dissatisfied with the decision from the administrative law judge, you may submit an appeal to the Labor and Industrial Relations Commission. You must do this within 20 days of the initial ruling. If you haven’t already, it is strongly recommended that you hire a workers’ compensation lawyer to help you through this process.

Your appeal is submitted through the Application for Review form. Along with the application, you and your lawyer will submit a brief, which outlines your case and explains why you disagree with the initial ruling. Though the Commission doesn’t allow for a new hearing, they may allow the parties to make their argument orally at a time set by the Commission.

Unlike your initial workers’ compensation hearing, your case is not presented to a judge, but three members of the LIRC. Their job is to determine if any legal errors occurred in your initial trial. They will also assess the credibility of the witnesses and the administrative law judge’s decision. Once the panel reviews your evidence and brief, they will either reach a new decision or agree with the administrative law judge’s initial decision.

Second Appeal: Missouri Court of Appeals

At times, the panel may rule in favor of the initial hearing, but there is still hope. You have the opportunity to appeal once again, within 30 days of the Labor and Industrial Relations Commission’s appeal decision. This time, however, your case is taken to the Missouri Court of Appeals.

Call Chris Miller for Your Workers’ Compensation Appeals

A denial does not have to be the end of your claim. You still have the opportunity to receive compensation, but you will need an experienced workers’ compensation lawyer to help. If your claim was denied, contact us at the Law Office of Chris Miller. Our team has years of experience handling work comp claims just like this, and we will fight to get you the help you need.