The workers' compensation system helps injured workers receive the medical care and financial resources they need to recover. Not every claim is approved, and this can be a source of significant distress for an injured person. An initial denial, however, isn't the end of the process and doesn't mean you should stop pursuing your claim. Here are a few important steps to take to fight for compensation.

What to Do if Your Workers' Compensation Claim Is Denied

1. Review the Reason for the Denial

The denial letter will always include the reason for the rejection of the claim. Denials are common in cases where deadlines were missed or the right paperwork wasn't submitted.

In these situations, contacting the claims adjuster can set the record straight, and they may be willing to let you submit the correct paperwork to get the claim back on track. If the claim was denied because an employer disputed the cause or severity of the injury, then you’ll likely have to get the help of a lawyer to prosecute the claim.

2. Find Out the First Step in Prosecuting A Claim

The denial will be in a document call a Form 43 and will outline the insurance company’s dispute with the claim. These steps vary by state. In Connecticut, the first phase is an informal hearing with a workers' compensation commissioner.

If a solution cannot be reached, a pre-formal hearing occurs. At this hearing, a timeline is laid out for the next steps, which ends with a formal hearing with a workers' comp commissioner.

If the claim is again denied, there’s an appeal to the workers' compensation review board. If that also results in a rejection, the final option is an appeal through the court system.

3. Consult an Attorney

It's in the claimant's best interests to hire an attorney right away and certainly no later than the pre-formal hearing stage of a case. This ensures that you understand your legal options, what will happen at every step, and what documentation and evidence will be required. Appeals are complex legal processes, and you should take every precaution to avoid missteps that can easily derail the procedures in place.

If your workers' compensation claim has been denied, contact the Law Office of Thomas L. Brayton III in Waterbury, CT. Attorney Brayton represents clients throughout New Haven and Litchfield counties in personal injury and wrongful death claims. He has more than 30 years of experience and was named an Avvo top-rated lawyer in 2019. Call (203) 591-8689 to schedule a consultation, or visit his office's website to learn more about how he can help with workers’ compensation claims.