My Claim is Denied, What Now?
In response to a properly filed Form 30C, the respondent insurance carrier has 28 days to file a Form 43 in denial of a workers’ compensation claim or to begin paying indemnity (wage replacement) benefits. Failure to properly contest a claim may result in preclusion of the respondent’s right to assert a defense to the claim.
Where the respondent has contested, or denied the workers’ compensation claim, the injured worker must request a hearing in front of a workers’ compensation commissioner to prove his or her claim. The actions of the claimant will vary based on the aspect of the claim being denied. For instance, where a respondent is denying the causal relation of medical treatment to the claimed injury, it is not necessary that the claimant prove the injury itself, but rather, that particular claimant must prove that the medical treatment is reasonable and necessary as a result of the work injury. Similarly, the respondent may contest the need for surgery, payment of ongoing indemnity benefits, change of physician or causal relation to the accident – just to name a few.
In most instances, when the claim has been denied, it is time to call CCB Law. Please don’t wait until your claim has been denied to seek CCB Law’s assistance, doing so may only delay your recovery.