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What Happens After a Denial of Your Workers’ Compensation Benefits?By Pyle Law, March 04 2021 7:34 pm
Even after your workers’ compensation claim has been initially denied, you still have legal rights. You can appeal your denial in the hopes that a judge will find you eligible for workers’ compensation benefits, and you should contact a Kansas workers’ compensation lawyer.
When your application for workers’ compensation benefits is denied, it is far from the final word. You still have a chance of getting the money that you need. However, you will need to go through a process to contest the denial.
Any claim denial will need to explain the reason why. For example, the stated reason for the denial could be:
The first thing that can help your cause is hiring a Kansas workers’ compensation attorney. In some cases, the claim denial could be the result of a misunderstanding, and a conversation with the insurance company can clarify things.
For most denials, you would need to go through the workers’ compensation appeals process. In Kansas, your first level of appeal is to an administrative law judge (ALJ) who handles contested workers’ compensation claims. You would need to show that your case meets the legal requirements for workers’ compensation benefits.
If the ALJ does not rule in your favor, you can appeal that decision to the Kansas Workers’ Compensation Appeals Board. You would need to file this appeal practically immediately after the ALJ decision as you have ten days. The Appeals Board performs the function that a state court otherwise would. They have the power to grant or deny benefits and change any part of the ALJ’s decision.
Workers’ compensation appeals will involve the judge(s) reviewing the record and making their determination about your eligibility for benefits. In some cases, the judge will decide whether an in person hearing is necessary. Legal help is a must to present your arguments to the judge in a way that shows that you legally deserve workers’ compensation benefits.
In general, the workers’ compensation claims and appeals process operates rather quickly. There are tight deadlines for filings, and missing them could jeopardize your ability to receive benefits. You need to make your most effective presentation in a short period of time.
The good news is that very few workers’ compensation claims are denied. Most of those that are denied end up being converted to paid claims after you either clear up the misunderstanding or establish your legal entitlement. Hiring an attorney to help file your initial claim will put your best case forward from the very beginning and reduce the chances that your claim could be denied due to a misunderstanding. In some respects, the best way to deal with a denial is to make sure that it does not happen in the first place.
At Pyle Law, we have helped workers across Kansas as they sought the benefits that they needed to pay their expenses while they were injured. Call us at (620) 241-9000 or contact us online to schedule your free initial consultation, where you can learn more about your legal rights.