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Denied Workers’ Compensation – How Could a Lawyer Help

Legally Reviewed and Edited by: Terry Cochran

Being injured or suffering illness on the job can result in a debilitating and difficult time. Usually, workers’ compensation benefits help get you back on your feet and overcome the physical and financial hardships. However, your workers’ compensation claim may be denied, leaving you to pay the fees on your own or forcing you into debt.

Working with an experienced workers’ compensation lawyer as soon as possible upon learning of the denial is the best way to determine what went wrong and how to move forward. It may be a simple mistake that you can clear up quickly, or it may require a lengthy appeals process.

Whatever the reason for the denial, seeking legal advice from the law firm of Cochran, Kroll & Associates, P.C., in Michigan, can help you change that denial into an approval. Knowing the workers’ compensation system inside and out, our lawyers review the denial reason, file necessary appeals, and represent you at mediations, hearings, and trials.

Review Reasons for Workers’ Comp Claim Denial

An experienced workers’ compensation insurance attorney knows how to decipher the reasons cited for your denial and the next steps. Some common reasons for workers’ compensation denials include:

  • Missed deadlines: A timeline begins the second you are injured at work. You must notify your employer as soon as possible, although you have 90 days to do so. Next, you need to file your workers’ comp injury claim. Although you have up to two years from the job injury date to file a workers’ comp claim, the sooner you file, the sooner you start receiving benefits. If you miss any of these deadlines, it is cause for denial of your claim.
  • Dispute of claim by employer: Your employer and insurance company may dispute your claim, stating that it is not work-related. Their reasoning can be that you were not working at the time of the injury, you were participating in some type of misconduct at the time of the injury, or your illness or injury did not result from workplace exposure or accident.

Other common reasons cited for denial of a workers’ compensation claim are a medical condition that doesn’t meet state guidelines, or you filed a claim after leaving the job where you suffered a work injury.

Your workers’ compensation attorney will review your denial letter to see if a simple remedy is available. If the employer or insurance company is disputing whether the injury or illness is work-related, you need to compile records to prove otherwise.

Your attorney can efficiently gather evidence supporting your claim, including witness accounts and medical records. Then, your attorney can enter into discussions and negotiations with the employer and insurance company. If your case remains unresolved, the next step is to file an appeal.

Denied Workers' Compensation

File An Appeal

An attorney can review all evidence of your claim and determine if you have a case. The appeals process is complicated, involving specific steps taken in exact order. In the state of Michigan, your attorney must first file an application for mediation or hearing with the Michigan Workers’ Compensation Agency. The benefit of working with a local attorney is their familiarity and experience working with the local office already.

Negotiate at Mediations and Hearings

Once the agency reviews the application, they may schedule a mediation or move directly to a hearing, depending on the circumstances. If you only file a request for reimbursement of medical treatment expenses, you can settle your claim in a mediation, where your attorney will work to reach a voluntary settlement on your behalf.

If no voluntary settlement is reached, or you are ineligible for mediation, the agency schedules a hearing before a magistrate or an administrative law judge. The hearing allows the judge to review your case and to schedule a trial date.

Represent You at Trial

During a non-jury trial, your lawyer presents the gathered evidence for your claim and provides witnesses. Following strict procedural rules and court protocols, he or she will also give legal arguments for your injured workers’ compensation claim before the judge.

File Additional Appeals

If your claim is again denied, your attorney can file another apparel, this time to the Michigan Compensation Appellate Commission. This requires the compilation of all documents, trial transcript, recorded witness statements, and the final decision. A written argument on why your case should be granted will accompany all this for review by the Commission.

If additional appeals are necessary through the Michigan court system, you need a dedicated workers’ comp lawyer to lead you through the process. You may be eligible to receive payment benefits during this time.

While a workers’ compensation denial can be disappointing, it doesn’t have to end there. By hiring a workers’ comp attorney, you can take the steps necessary to appeal the decision and fight for what you rightfully deserve.

Contact Your Michigan Workers Compensation Lawyers Today

If an injury occurs while working and you receive a denial to your workers’ compensation claim, contact our experienced legal team here at Cochran, Kroll & Associates, P.C. We will thoroughly review your claim and resulting denial and advise you on the next steps to take. Call us at 866-MICH-LAW to schedule a free consultation today.

Disclaimer : The information provided is general and not for legal advice. The blogs are not intended to provide legal counsel and no attorney-client relationship is created nor intended.

Emily is a writer and legal professional with experience as a law firm paralegal and non-profit legal administrator. Prior to her legal career, Emily earned her Bachelor's Degree in International Affairs and worked with a government consulting group out of Washington, D.C. Today she splits her time between the Florida coast and the North Carolina mountains.



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