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What can you do if your workers’ compensation claim is denied?

On Behalf of | Apr 25, 2024 | Workers' Compensation

If you’re injured on the job, your employer should pay for the medical care and other benefits through workers’ compensation. This is how the system is supposed to work, but unfortunately there are many cases in which workers receive much less than they deserve, or have their claims denied altogether.

If this happens to you, you can continue to pursue your claim through a hearings and appeals process.

Filing a claim

When you are injured at work, you should report the injury to your employer as soon as possible. Generally, you must do so within 30 days or you may lose your right to claim benefits. After receiving your report of injury, your employer notifies the Virginia Workers’ Compensation Commission. The commission then sends you information about your rights.

If you have not received everything you need from your employer and/or their insurer at this point, you file a claim with the commission, telling it what benefits you seek. For example, you may ask for temporary total disability benefits if your injuries will completely prevent you from working for a period. (You must have medical authorization to make this claim.) At this time, you also request a hearing.

The commission then sends an order to all involved parties, requiring the administrator of your employer’s compensation plan to respond within 30 days. At this point, the administrator may approve your plan. If they don’t, you send your medical records to the commission and go forward with the hearing process.

Hearings and appeals

At the hearing, a deputy commissioner hears evidence from both sides and then writes a decision. If you disagree with the decision, you have 30 days to file an appeal.

The first appeal goes before the full commission. After that, you could conceivably continue to take your case before the Virginia Court of Appeals and then on to the Supreme Court of Virginia.

Note also that the Workers’ Compensation Commission encourages parties to resolve their disputes through mediation outside of the hearings process.

At any stage in this process, it’s a good idea to seek out advice from experienced professionals.