Injured workers call us regularly because their workers’ compensation claim is denied by the adjuster assigned to the case. This is very common, and part of the game that insurance companies play to get out of paying benefits. After all, if people just walk away from denied claims, then the insurance company doesn’t have to pay anything at all.
Insurance companies come up with lots of reasons to deny workers’ comp claims. They will try to say that the injury didn’t occur at work. Sometimes they even try to say that no injury occurred at all! It’s pretty typical for an adjuster to say that they haven’t received any medical evidence of an injury. Of course, that’s easy to say when you don’t actually ask for the medical records. The trend right now is to say that all of your injuries are pre-existing. Yeah, right.
What Do I Do If My Workers’ Compensation Claim Is Denied?
If your workers’ compensation is denied, then you have to initiate dispute resolution. Dispute resolution is the process of going through a set of hearings at the Division of Workers’ Compensation. First, you attend a Benefit Review Conference. After that, you see a judge at the Contested Case Hearing. And if you lose there, you can file an appeal with the Appeals Panel.
To begin this process, you must request a benefit review conference. There’s just a form to fill out and file with the Division. Remember to get medical treatment. Those records will be your evidence of the ongoing issues you are having with your work injury. You will want to consult with a Texas workers’ compensation attorney. Your odds of winning increase with representation – and a consult is free. When your workers’ compensation claim is denied, you want all the help you can get to establish your claim. Everything is riding on the outcome.
If you want to read up on the hearing process, get a free copy of our book, “The Ultimate Survival Guide For Texas Injured Workers: Everything You Need To Know To Beat Insurance Companies At Their Games.” That book has the info necessary to understand what is going on at every stage of your case. Also, feel free to call us at any time with questions that come up along the way.