You put in the hours at your job, expecting that if you get hurt, workers comp will take care of you. But then you file a claim, and it gets denied. Don’t panic. Getting denied isn’t the end of the road — you still have options.
This article will walk you through the steps to take if dealing with a denied workers comp claim and how a Nashville workers compensation attorney can help protect your rights if this happens.
Understanding Why Your Workers Comp Claim Was Denied
The first thing you need to do is to find out why your claim was denied. Common reasons in TN include lack of evidence the injury occurred at work, questions about the severity of your injury, or issues with required paperwork.
The insurer may also argue your injury isn’t severe enough to warrant lost wages or time off work. Have your doctor re-evaluate your condition and limitations, then submit their findings and request another medical review. Get a second opinion from an independent doctor if needed.
Your Rights to Appeal a Denied Workers Comp Claim
Getting a denial letter for your workers comp claim can be frustrating, but don’t give up hope. Tennessee law protects your right to appeal a denied claim. You have the power to fight the decision by filing a request for a hearing with the Tennessee Department of Labor.
You must request a hearing within 15 days of receiving the notice that your claim was denied. To request a hearing, file a written petition with the Tennessee Department of Labor. Explain why you believe the denial was unjust and provide any evidence to support your claim, such as medical records or witness statements.
Meet with your doctor to review your medical records and get their input on your condition. Ask if they will provide a letter of support for your claim or be willing to testify on your behalf. Their medical opinion and expertise can help strengthen your case during the appeals process.
Steps to Take to Appeal Your Denied Claim
When your workers comp claim gets denied, don’t lose hope. You can appeal the decision and fight for the benefits you deserve. The appeals process can be frustrating, but taking it step by step will increase your chances of getting your claim approved.
File a Petition for Benefit Determination Review
Your first step is to file a Petition for Benefit Determination Review with the Tennessee Bureau of Workers’ Compensation. You must do this within 15 days of receiving the notice that your claim was denied. In this petition, clearly state why you disagree with the decision and any evidence supporting your claim.
Request a Benefits Review Conference
If denied again, you can request an in-person Benefit Review Conference. This conference allows you to meet with a mediator to present evidence and testimony supporting your claim. The conference is less formal than a court hearing and aims to resolve issues through compromise and agreement.
File Suit in Chancery or Circuit Court
If you’re still unsatisfied, you have the right to file a lawsuit in Chancery or Circuit Court to appeal the decision. At this point, you should hire an experienced workers comp attorney to represent you. They can collect evidence, handle the legal procedures, and argue your case in court.
Reach Out to an Experienced Nashville Workers Compensation Attorney
Don’t lose hope if your workers comp claim has been denied. Many seemingly straightforward claims are denied initially, only to be approved after going through the appeals process. However, navigating the appeals process in Tennessee can be complicated, and there are strict deadlines you must meet.
An experienced Nashville workers compensation attorney can help you navigate the complex rules, ensure all deadlines are met properly, and give you the best chance of overturning a denied workers comp claim. Call our office today at (615) 502-4477 for a free consultation.