What To Do When Your Workers Comp Case is Denied in DC
What Is a Notice of Controversion and What Does It Mean for My Case?
When an insurance company denies your claim for benefits, they file a Notice of Controversion. This form explains why your claim was denied. In DC, insurance companies don’t have to pay workers’ compensation benefits right away, and there’s no initial award. They can choose to pay if they believe your claim is valid, but they can stop payments anytime unless you get a Compensation Order to force them to pay.
How to Contest a Notice of Controversion
You can challenge a Notice of Controversion by asking for either an informal conference or a formal hearing.
You can ask for an informal conference. Which is a way to resolve issues without going to court. There are no court reporters or witnesses, and no sworn testimony. A claims examiner helps mediate and will give a recommendation within 30 days. If the issue isn’t resolved, they will provide a non-binding recommendation.
While many lawyers opt for an informal conference after a claim is denied, we often prefer a more direct approach and go straight to a formal hearing.
Why Choose a Formal Hearing?
If you can’t work because of your injury and aren’t getting paid, the slow workers’ compensation system can be really frustrating. It may take months just to get a hearing date, and even longer for a decision. An informal conference isn’t binding, so if you win, the insurance company doesn’t have to pay. They can simply ask for a formal hearing, which can delay payments even more.
That’s why we suggest going straight to a formal hearing. This process requires full disclosure, and the judge’s decision is binding. If you win, the insurance company must pay your benefits.
A formal hearing also puts pressure on insurance companies to pay up. Even if they appeal, they still have to provide payments during the review. There are many factors that can influence how quickly you receive benefits, and insurance companies often use tactics to deny claims and cut costs.
Need Help with a Contested Claim?
If you want to learn more about how to fight this unfair situation, order “Protect Your Rights: The Ultimate Guide to DC Workers’ Compensation“. This guide provides critical information about handling a workers’ compensation case and understanding your rights as an injured worker. We’re offering it for free to injured workers in the DC area, so order today while supplies last!
Give us a call us at (202) 393-3320 you can also schedule a free 15 minute consultation here.