What are my legal options if my workers' comp claim is denied?

Many employers carry workers' compensation insurance, which is meant to pay for medical costs and wage loss for injured workers. Filing a workers' compensation claim is not easy. If there are any errors in the paperwork or if the insurance company isn't convinced that you have a viable claim, your claim can be denied.

That's why it's important to always consult with an experienced workers' compensation attorney before filing a claim. Having the right attorney on your side can maximize your chances of receiving benefits.

Why would my workers' compensation claim get denied?

There are many reasons why a workers' compensation claim may be denied. The most common reasons are:

• An injury was reported too late — In Mississippi, you have 30 days to report an injury to your employer. The sooner you report an injury, the better.
• Your claim was filed too late — The time limit to file a claim can be relatively short and complicated to determine, so the sooner you file, the better.
• Your injury was difficult to prove — Some injuries and illnesses can be difficult to prove. For example, if you are experiencing mental or emotional anguish, it can be hard to link that to your job without sufficient evidence. The same can be said about certain illnesses and medical conditions.
• You never sought medical attention — It's important that you always seek medical attention promptly after sustaining a workplace injury. Early treatment can help prevent an injury from getting worse and speed up the recovery process. In addition, getting medical attention can make it difficult for an insurance company to argue that your injury was exaggerated.
• An employer disputes the claim — Your employer may dispute your workers' compensation claim and argue that it happened outside of work or due to reckless behavior.

What should I do if my claim was denied?

If your workers' compensation claim was denied, you're not completely out of options. You must first file a Petition to Controvert with the Mississippi Workers’ Compensation Commission within two years of the date of your injury. If the workers' compensation carrier pays for any of the injured worker’s medical treatment, then denies the claim, the statute of limitations is only 1 year to file a Petition to Controvert.

Your case will then be assigned to a workers' compensation judge. You and the insurance company will both have the opportunity to provide a written response. If a claim can't be settled through a negotiation, then you will need to appear before a judge at an administrative hearing.

At this time, both sides present their arguments, question witnesses and present evidence. The entire appeal process can take several months. Once a decision has been made by a judge, you will be notified in writing.

If the judge doesn't rule in your favor, you can still appeal the commission's decision by submitting a petition for review within 20 days of the judge's decision. You can submit a written brief to the commission to argue your case. If the commission doesn't rule in your favor again, you can take your case to the state courts, including all the way to the Mississippi Supreme Court. Your appeal to the state courts must be filed within 30 days of the last commission decision.

Why hire a workers’ compensation attorney?

If your workers' compensation claim was denied, you don't have to give up. An experienced attorney at Tabor Law Firm, P.A. can help you explore your legal options and advocate for you in court. We know how the legal system in Mississippi works and how to deal with stubborn insurance companies.

To learn more about your legal rights, contact our firm online and schedule your free consultation.