After a denied workers’ compensation claim, you may worry your injury will destroy your financial security as well as your physical health. Fortunately, you can appeal the decision to deny your request.
Speak to your employer
Before you take your case before a workers’ compensation judge, you may want to discuss the matter with your employer and the insurance company. Ideally, you will learn there was missing information or a clerical error you can easily correct, resulting in the processing and approval of your claim.
Request a settlement conference
You may meet with the insurance adjustor informally in an attempt to work out the problem with your claim, if the company agrees to a settlement conference or prehearing conference. You and the insurance company may have attorneys present. Although the meeting does not involve any legal fact-finding, you may request that a prehearing administrative law judge attend. The settlement conference may take place after you request a full hearing and as you wait on your court date.
Request a full hearing
After you receive a denial letter for your claim, you have 45 days to file an Application for Hearing to contest the decision. This is a formal legal proceeding that takes place in front of an administrative law judge. As in any other court case, you can present your argument to the judge and provide evidence that the insurance company should accept your workers’ compensation claim. The insurance company and/or your employer will also have the opportunity to explain the reasons behind the denial of your claim.
File a Petition to Review
A confirmed denial at the hearing may seem like the end, but you can file a further appeal. You must do this within 20 days of your receipt of the judge’s order. You must then submit a copy of the hearing and a brief that describes your supporting arguments. The judge will either make a decision or submit the appeal to the Industrial Claims Appeals Panel.
Appeal in court
You have the option to take your case to the state’s appellate court system, and even to the Colorado Supreme Court. However, there is no guarantee your case will be heard.