Receiving a denial for your workers’ compensation claim can be incredibly stressful. In Alabama alone, over 33,500 nonfatal workplace injuries and illnesses were reported in 2022. Understanding the denial process and your rights is crucial to securing the benefits you deserve.

A Huntsville workers’ compensation lawyer can be invaluable during the complex appeals process, protecting your rights and maximizing your chances of overturning the denial. At Tyler Mann Injury Law, we have the expertise to protect your rights and maximize your chances of overturning a denial. Let us guide you through every step.

Common Reasons for Workers’ Comp Denials

In Alabama, you can file a workers’ compensation claim after a job-related injury to receive partial wages and coverage for medical care. While you are entitled to workers’ comp benefits for on-the-job injuries, your claim may be denied for the following reasons:

  • Missed Deadlines: Alabama law requires you to report your injury to your employer within five days of the incident. If you wait too long to notify your job, it could result in a denial.
  • Disputed Work-Relatedness: Workers’ compensation benefits only apply if you were injured while working. Your application may be denied if your employer or insurance company argues that your injury didn’t occur at work or isn’t job-related.
  • Failure to Seek Approved Medical Treatment: In Alabama, you must see a doctor approved by your employer or their insurer for your claim to be valid. Seeing your primary care provider without prior approval could lead to a rejected claim.
  • Lack of Medical Evidence: Successful workers’ compensation claims rely on solid medical evidence. Your claim may be denied without adequate documentation, like medical assessments or care plans.
  • Pre-existing Conditions: If your employer argues that your injury is due to a pre-existing condition rather than a work-related incident, your claim may be dismissed.
  • Drug or Alcohol Use: If there’s evidence that you were under the influence at the time of the injury and you refuse a drug or alcohol screening, your claim will likely be rejected.
  • Independent Contractor Status: Workers’ compensation typically doesn’t cover independent contractors. Your claim can be rejected if your employer argues you’re not an employee.

What To Do if Your Claim Is Denied

If you file for workers’ comp and they refuse to pay your claim, you have the right to an appeal. However, you have two years from the date of injury or last compensation payment to file a lawsuit for workers’ compensation benefits.

To protect your rights, take the following steps as soon as you receive the denial letter:

  • Review Denial Letter: Carefully review the rejection letter to determine the reason for the denial. It will explain why the claim isn’t being paid and your rights to challenge the decision.
  • Gather Additional Evidence: Gather additional medical records, witness statements, and other supporting documents. Detailed evidence can address the reasons for the denial and strengthen your case.
  • File an Appeal: You must submit your appeal request in writing, by mail, or online. Sign your appeal letter and include your name, Social Security number, and a detailed explanation of why you disagree with the decision.
  • Meet Deadlines: You have 15 calendar days from the mailing date of the denial notice to file a written appeal with the Hearings and Appeals Division of the Alabama Department of Labor. You have only seven calendar days if you received the notice in person.
  • Prepare for a Hearing: If your appeal is accepted, an Administrative Hearing Officer will schedule a hearing. You’ll need to present evidence and arguments supporting your claim.

Do You Need an Attorney for the Appeals Process?

While you have the right to represent yourself in a workers’ compensation appeal, the process can be complex, time-sensitive, and overwhelming. An experienced workers’ compensation attorney at Tyler Mann Injury Law can do the following to help with your case:

  • Meeting Critical Deadlines: Our team stays on top of all important dates, ensuring your appeal is filed within the strict time window mandated by Alabama law. We’ll ensure you don’t lose your right to appeal due to missed deadlines.
  • Building a Strong Case: We know what evidence can bolster your workers’ compensation appeals claim. Our attorneys will gather medical records, expert opinions, and witness statements to strengthen your appeal argument.
  • Representing You at Hearings: If your case goes before an Administrative Hearing Officer, our attorneys will present your case professionally and persuasively, arguing for your right to benefits.
  • Handling Complex Cases: For issues like permanent disability claims or disputes over work-relatedness, our in-depth knowledge of Alabama workers’ compensation law can help you achieve a favorable outcome that provides the financial support you need after a work injury.
  • Managing Further Appeals: If necessary, we’re prepared to take your case to the Board of Appeals, fighting tirelessly for your rights at every level of the appeals system.

At Tyler Mann Injury Law, we know the stress and uncertainty of a workers’ compensation denial. We aim to win your appeal and secure the maximum benefits you’re entitled to under Alabama law.

Don’t Let a Denial Stand in Your Way

A workers’ compensation denial can be disheartening, but it’s not the end of the road. You can still secure coverage for medical expenses and lost wages with qualified legal guidance. We navigate the appeals process for you, streamline your case, and fight to get you the benefits you deserve.

Contact us for a free consultation to discuss your situation, and let our experienced legal team help you get the workers’ comp benefits you are owed.