Workers’ Compensation Claim

Workers’ Compensation Claim Denial in Virginia: How Can You Appeal the Decision?

If you have sustained injuries at work, you will need workers’ compensation benefits for your recovery while you cannot go to work, cover your household expenses, and take care of yourself. However, this does not mean the insurance provider of your employer will willingly help. 

A lot of employees in Virginia are denied workers’ compensation benefits before they get them. Many of them may just accept the denial without appealing it. However, you do not need to suffer due to the workplace accident you were involved in. If you are not sure what to do, get legal advice from an experienced workers’ compensation attorney. An attorney can guide you through each step of the appeal process. 

Reasons a Workers’ Comp Claim Can Be Denied

Your lawyer will determine the reason for the denial. The denial letter must state this reason; however, it may not be easy to understand for a non-lawyer. The following are some of the reasons a workers’ comp claim can be denied:

  • Lack of evidence. Your workers’ comp claim can be denied if you do not give enough evidence of your injury and the accident to the insurance provider. If you are hurt, you may find it hard to dig through the necessary evidence. Thankfully, your attorney can collect this evidence for you.
  • Workers’ comp time limits. If you want to file a workers’ comp claim in Virginia, you only have two years from the work-related accident to do so. Filing a claim beyond this time limit can result in the denial of your claim. 
  • No medical treatment. You need to see a doctor following a workplace accident. Your claim can be denied if your injury does not require medical care.

How to Appeal a Denied Claim

If your workers’ comp claim has been denied, you can appeal this decision and receive the benefits you are entitled to. After determining the reason for the denial, it is time to collect additional evidence for your worker’s comp claim and prove your due compensation. Then, you can take your case to court.

If your employer’s workers’ comp insurance company denied you benefits, you can take your claim to the Virginia Workers’ Compensation Commission. The Commission will hear the story of both sides as well as review the statements of the insurer and the new evidence your attorney presents. Then, they will decide whether give you a settlement or uphold the decision of the insurer. 

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