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Under the Code of Virginia Title 65.2, injured workers can ask for compensation following workplace injuries that led to lost wages, medical costs, and other damages. Your employer or your employer's insurance company may fight your workers' compensation claim, and the claims adjuster may deny it.
Understanding what to do with a denied workers' compensation claim is crucial, as you may have mounting bills and be unable to work. Taking the proper steps in the appropriate time frame increases your chances of winning at a hearing.
Common Reasons Behind Workers' Compensation Claim Denial
There are several reasons why your employer may deny your workers' compensation claim. Some of the more common reasons include the following:
- You didn't tell your employer about your injury within the time required under the law.
- You failed a drug test.
- You waited too long to seek medical attention or didn't seek it at all.
- You filed your claim after you lost your job.
- You missed the filing deadline for your workers' compensation claim.
- You have a preexisting condition that led to your injury
- There were no witnesses to your accident.
- Your accident wasn't work-related.
If you are denied, there is a hearing process through the Virginia Workers' Compensation Commission and then through the courts. An experienced workers' compensation attorney can help you gather the information you need to help prove your denial was unjustified.
Here's What You Should Do About a Workers' Comp Claim Denial
You should take several immediate steps after receiving a workers' compensation denial letter. Acting quickly ensures you have the evidence the Commission needs to overturn that decision when you dispute it.
Gather Medical Reports and Time Sheets
Information from your doctor about your medical care can help establish that your workers’ compensation claim is legitimate. You don't have a claim if you don't have legitimate damages. Ask for complete reports of every visit related to treatment for your workplace injury. Something that might not seem important to you could prove vital when appealing a workers' comp claim denial.
Timesheets are also very helpful because, under Virginia workers' compensation claims laws, you must be able to show that the injury occurred while you were at work or during a work-related function. Keep or gather any other correspondence, such as emails or work orders, showing that your injuries occurred while you were working and that you deserve help under compensation law.
Hire a Workers' Compensation Lawyer Stat
Getting legal representation is so important following a workers' comp denial that the Virginia Workers' Compensation Commission recommends having your own attorney. The Commission believes you are at a disadvantage without one.
Hire your lawyer before you talk to your employer or the insurance company. Never speak to them alone, as they may try to get you to say something that casts doubt on your claim and use it against you later. They may also press you to drop your claim if you show up alone or offer you much less than you deserve.
An experienced workers' compensation attorney knows how to deal with insurance company tactics and which steps you should take under Virginia law. They can also help if your employer retaliates against you by cutting your hours or otherwise mistreating you. Your employer will have an attorney, and you should have one too.
How the Workers' Compensation Process Works
If your Virginia workers' compensation claim is denied and you can't settle with your employer out of court, there is a process by which you can still seek compensation. The first step is a hearing before a Virginia Workers' Compensation Commission deputy commissioner. This hearing is similar to a court case, with both sides presenting evidence and people testifying under oath.
This first hearing is critical, as it is the last chance to present evidence to support your claim. Appeals following this first attempt are based on your claim of errors by the deputy commissioner or the full Commission, such as not correctly interpreting the law.
Following that initial hearing, both parties have 30 days from the opinion's issuance to further appeal to the full Commission. If you are still denied the compensation you deserve for your workplace injuries, you can appeal to the Virginia Court of Appeals and then to the Supreme Court of Virginia.
You must meet several deadlines in your initial claim for workers' compensation and as part of the appeals process. Missing any of these deadlines could mean you receive no compensation. You must also have the proper evidence and any witnesses ready when you go in front of the Commission during your hearing.
An experienced workers' compensation attorney is well-versed in Virginia workers' rights laws and knows what evidence you need to win your case. They can help you gather evidence, talk to witnesses, and stop your employer or their insurance company from using tactics designed to undermine your case.
We Expertly Handle Workers' Compensation Claim Denial Cases
If you suffered a workplace injury and your employer denied your claim, contact our experienced workers' compensation attorneys at the Commonwealth Law Group. We can help you prove that your injury occurred as a result of your employment and that you deserve workers’ compensation benefits for lost wages, medical bills, and other damages.
The period following a workplace injury is stressful enough. Let us handle dealing with your employer and their insurance company for you.
If you have been injured at work or through the negligence of another individual or entity, contact us at (804) 999-9999 or or use the form below to connect with our legal team. We will fight to get you the justice you deserve.