Denied and Confused? Here’s What to Do Next

A denied workers’ compensation claim can feel like a major setback, but it doesn’t mean you’re out of options. By taking the right steps, you can challenge the denial and fight for the benefits you deserve. At Poirier Law Firm, we’re here to guide you through this process.

• Understand Why Your Claim Was Denied

A formal WC-3 controvert form filed with the State Board of Workers’ Compensation outlines the reasons for claim rejection. Common reasons include:

• Missed deadlines for notifying your employer or filing your claim.
• Insufficient evidence linking your injury to your workplace.
• Pre-existing conditions that the employer argues caused your injury.

If the reasoning is unclear, consult with an attorney to interpret it.

• Consult an Experienced Workers’ Compensation Attorney

Navigating the hearing process can be complicated. A skilled attorney can help you:

• Understand the denial and build a strong case.
• Represent you in hearings and negotiations with the employer’s insurance company.
• Advocate for your rights to ensure you receive the benefits you’re entitled to.

• Act Quickly 

When a workers’ compensation claim is denied, you must file for a hearing. Key steps include:

• File a WC-14 form to request a hearing with the State Board of Workers’ Compensation.
• Act quickly, as there are strict deadlines for filing a hearing request.
• Most cases require filing within one year of the date of injury or last medical treatment.

• Gather Evidence to Strengthen Your Case

Supporting evidence is crucial to winning your hearing. Make sure to:

• Obtain detailed medical records documenting your injury and any treatments.
• Collect witness statements from colleagues who saw the incident or can verify unsafe working conditions.
• Secure copies of accident reports and any correspondence with your employer or their insurer.
• Compile visual evidence, like photos of your injury or the accident site.

• Seek Medical Evaluation

If your employer disputes the cause of your injury, getting a comprehensive medical evaluation can help link your injury to your job.

• A doctor’s testimony or detailed report can clarify how work-related activities contributed to or worsened your condition.
• If your claim involves a pre-existing condition, gather medical evidence showing that your job aggravated it.

• Avoid Common Pitfalls

Mistakes during the hearing process can jeopardize your case. To stay on track:

• Don’t delay taking action. Time is critical in workers’ compensation appeals.
• Avoid direct communication with the insurer without legal representation. They may use your statements against you.
• Be thorough in your documentation. Missing details can weaken your claim.

Poirier Law Firm Is Here to Help

A denied claim isn’t the end of the road—it’s an opportunity to fight back. At Poirier Law Firm, we specialize in workers’ compensation hearings and are dedicated to guiding you through every step of the process. Over the past 22 years, our team has worked to get upwards of 80% of our clients denied cases paid before even having to go into deposition or litigation. Take action today. 

Contact Poirier Law Firm for a consultation and let us help you move forward with confidence toward the compensation you deserve!