If your workers’ comp claim is denied by either the insurance company or your employer, you could be worried about your future and finances. If you have a serious injury and you have limitations on the work you can do, or if you aren’t able to work at all, it can be a very stressful situation. If your claim is denied, you have the right to appeal the decision in Indiana and shouldn’t give up. However, you don’t want to just get another rejection letter so it’s important to work with an experienced claim denial attorney.
Gather Appropriate Evidence
Before you file an appeal, you should look at the denial letter you get. This will let you know the reason for denial so you can be guided in how to appeal. The insurance company should include this information for you, but if it’s missing, you can reach out to a lawyer. The reason for denial will help you figure out what kind of evidence you need. For example, if you are being denied because the insurance company thinks you were injured outside of work then you need eyewitnesses, surveillance footage, and a report of the accident to prove it was in fact at work. An attorney will help you be able to respond to the accusations and help reverse the denial. You should also be sure to gather any evidence if your claim wasn’t handled justly. For instance, if you think your employer didn’t report in time, you will need to let the Indian Workers Compensation Board know.
An Informal Meeting
Discussing the claim and your evidence with just an informal meeting might be all you need to do in order to get your benefits. For this type of meeting, you will sit down with the insurer and your employer. You will share the additional evidence you gathered and discuss the evidence. If they accept, you should get the benefits on the spot. Sometimes this is all it takes in order to get compensation.
An Appeals Hearing
If you aren’t one of the injured workers lucky to get this sorted out with an informal meeting and the insurance company or employer is still disputing the claim then you take it to the Indiana Workers Compensation Board. Your claim will then be reviewed by a board member who will decide whether to overturn the denial or uphold the decision. Since this hearing is more formal, you should work with a workers’ comp lawyer to prepare the appeal. An attorney can present the evidence and fight for your case and show why you are entitled to the benefits. Once both sides have taken a turn then the board member decides if you will get a settlement and how much you get. Since you have the burden to prove the facts in order to appeal your denied claim, you have the right to work with an attorney at any point in the process. Working with an attorney as soon as possible can give you the greatest benefit. The case can involve technical provisions of the law, rules of evidence, and more. If you don’t follow the rules then you could lose the case.
Getting Workers Comp Benefits in Indiana
You don’t need to prove your employer was at fault in order to get benefits. This insurance is similar to no-fault insurance. It will pay regardless of who is at fault, unless the injury is due to your own misconduct, such as being intoxicated on the job or not wearing the proper safety equipment. Since you are entitled to benefits regardless of who caused the accident, you can’t sue your employer for injuries that happened on the job. The fault is only a consideration if a party other than your employer or a co-worker caused the injury. If you file a lawsuit and prove a third party was at fault for the accident then you may be entitled to other types of compensation.
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