Reviewing A Workers’ Compensation Denial Letter

Hoping for good news when you open your mail only to be confronted with a workers’ compensation denial letter can be disheartening and stressful. While it’s normal to be frustrated, recognize that a denial is not the end of the road.

Before giving up hope, know that a successful appeal could be in reach with the support of a Baltimore personal injury lawyer who has experience defending a person’s workers’ compensation rights. From looking into the reasons for denial to gathering compelling evidence and preparing for a hearing, a lawyer’s expertise is invaluable in pursuing the benefits you deserve.

Reasons for Denials and Gathering Additional Evidence

Understanding why your workers’ compensation claim was denied is the first step in the appeals process. Your next steps can be strategized when you are aware of the denial being due to insufficient medical documentation, missed deadlines, or an insurer asserting that the injury was not as severe as stated or did not occur during the course of employment.

The denial letter should outline the grounds for denial and any missing information or discrepancies in your claim. Pay close attention to:

• Detailed reasoning. Note the insurer’s explanation for the denial.
• Required documentation. Identify any additional documents or evidence requested.
• Deadlines for appeal. Be aware of the timeframe within which you must file an appeal.

With this knowledge in place, you can begin the process of strengthening your appeal by gathering relevant evidence.

For example, if there is an issue with healthcare documentation, you can obtain comprehensive medical records that detail your injury, treatment, and the connection to your workplace. In other situations, collecting statements from coworkers or other witnesses who can attest to the incident or securing a medical expert’s opinion may help substantiate your claim.

Submitting a Request for Reconsideration

Once you have reviewed the denial letter and gathered documentation, file an appeal with the Maryland Workers’ Compensation Commission (MWCC). This involves completing and submitting the necessary forms to the MWCC within the specified deadline. include all additional evidence and documentation that addresses the reasons for the initial denial.

If your appeal progresses to a hearing, a Baltimore personal injury lawyer can assist in organizing your testimony to clearly present the facts of your case, ensuring all supporting documents are properly submitted, and preparing you to answer questions from the judge, employer, or insurance company representatives.

During the hearing, both sides will present their cases before an administrative law judge. The process typically includes opening statements, presentation of evidence, questioning, and closing arguments where both parties summarize their positions.

What was included in your denial letter? Carefully reviewing the information provided in a workers’ comp claim denial is essential when building a strong appeal. It is normal to be overwhelmed when healing from a workplace injury and trying to obtain the compensation you need to pay off injury-related expenses, but with the guidance of the knowledgeable legal team at Iamele & Iamele, LLP, you can effectively navigate the appeals process. Contact us to book a confidential consultation.