What are the Steps in the Workers’ Compensation Appeals Process?

You may still be able to obtain workers’ compensation benefits if your claim for benefits was denied by your employer of the insurance company. Virginia has an appeals process for denied claims, and you may be able to present new information to overturn the original decision about your claim.

The Richmond workers’ compensation lawyers at Geoff McDonald and Associates understand injured workers may have many questions about the appeals process and whether it may be possible to overturn a denial.

That is why we offer injured workers a free, no-obligation legal consultation to discuss their claim and how we may be able to assist them in pursuing benefits.

Below, learn more about the appeals process for a denied workers’ compensation claim in Virginia.

What Can You Do After Receiving DENIAL from Your Employer or the Insurer?

If your application for benefits is denied by your employer or workers’ compensation insurer, you will be notified either by your employer or its workers’ compensation insurance carrier. The notice should explain why your claim was denied. For example, it may say the injury was not work-related or there were errors in your application. Please keep in mind that Virginia has the HIGHEST DENIAL RATE out of all 50 states and there are many loopholes in the law which allow your employer to weasel out of paying benefits you are owed.

Whatever the reason for the denial of your case, you have the right to file a claim with the Virginia Workers’ Compensation Commission (VWCC).  Also, you may be able to correct errors on your application or provide more information or evidence to help prove you should receive benefits for your injury.

If you hire an attorney and your employer does as well, you may be able to attempt mediation to resolve the dispute. This involves a neutral third party stepping in to try to reach a resolution both sides can agree on without going to court. This is an option you should discuss with an experienced attorney.

If you cannot reach a resolution through mediation, you file a claim with the VWCCC requesting a hearing before a Deputy Commissioner with the Virginia Workers’ Compensation Commission (VWCC).  At the hearing your attorney can present new evidence about why you should receive benefits.

If you disagree with the decision made by the VWCC, you can appeal it to the Full Commission.

You also have the option of appealing to the full commission. The Commission will review the transcript of the hearing, evidence you submitted, along with written briefs submitted by you and your attorney. You or your attorney may also be able to request making oral arguments in front of the Commission to bolster your claim. You need to point out a specific reason you disagree with the decision on your claim.

You have limited time to start an appeal, so it is important to contact a lawyer right away. There are also other deadlines throughout the process and if you miss one, you may lose the right to continue your appeal and may be unable to recover workers’ compensation benefits. You need to make sure to follow the procedures of an appeal, otherwise you could jeopardize your claim.

If you are unable to overturn the decision on your claim after it is reviewed by the Full Commission, your next option is to file an appeal with the Court of Appeals of Virginia.

Our Attorneys are Here to Help, Call to Set Up a Free Consultation

Unsure of what to do after your workers’ compensation claim was denied?

The experienced attorneys at Geoff McDonald and Associates are available to discuss your options. We have recovered millions in compensation on behalf of our clients, including many injured workers.

There are no upfront fees for our services – we are not paid unless our clients receive compensation for their damages. The initial consultation is also free of charge.