What to do if your Workers’ Comp Claim is Denied

Experiencing an accident on the job can be devastating, and a denied workers’ comp claim only adds insult to injury. There are several reasons why a claim may be denied for reasons like missing due dates or being under the influence of alcohol or drugs at the time of an accident. Once you receive notice that your claim has been denied, there are steps you can take to appeal it. Whether you are thinking about filing a claim, recently filed a claim, or your workers’ comp claim was denied, the attorneys at Shultz Legal are here to support you.

Common Reasons why Claims are Denied

There are multiple reasons why a workers’ comp claim may be denied. Some of the most common reasons include:

• Not filing a workers’ comp claim by the established due date. In Maryland, workers have 60 days from the date of the injury to file a claim, and the statute of limitations is two years from the date of the accident. Please note, workers must notify their employer within ten days of the accident.
• Someone may have made a mistake on the claim form, including the person making a claim or their employer. 
• An employer may claim you were not wearing the proper protective equipment or safety gear when the accident occurred. 
• Your employer may claim that you were under the influence of drugs or alcohol when the accident occurred. 
• Your employer could claim you intentionally injured yourself.

Next Steps after a Denied Claim

You may obtain claim status information in several ways, such as by telephone or through Maryland’s WCC Public Claim Information Inquiry. Once you receive the decision for your claim, if you disagree with it, you have a right to appeal it. First, you will have 15 days from the date of the notification letter to submit what is called an ‘Issues Form’ with the Commission. This form is mailed to the Commission and your employer’s insurer and used to request a hearing for your case when you disagree with the Commission’s initial decision. Hiring an attorney who specializes in workers’ comp law to assist you in the appeals process helps to ensure your rights are protected and you receive the benefits you deserve.

Once a hearing is scheduled, if you have an attorney, they will provide evidence to support your position. Some examples of evidence may include medical documents and testimonies from your doctor, a witness report from a co-worker, or documents related to your wages if you disagree with your workers’ comp payment. Once the hearing is over, the judge will make a decision. Under certain circumstances, such as newly available evidence or a legal mistake made by the Commissioner, you may have the option to request a rehearing within 15 days if it does not work in your favor. Finally, should a rehearing be denied, you have the right of appeal to the Circuit Court by filing a ‘Notice of Appeal.’ 

If you find yourself in a situation where you need legal representation, Shultz Legal can help. Call us at 410 505-7627 and let us help to protect your rights.