Qué hacer cuando su caso de compensación a los trabajadores es negado en DC
¿Qué es una notificación de controversia y qué significa para mi caso?
When an insurance company denies your workers’ compensation claim, it files a Notice of Controversion. This means the insurance company is disputing your claim or refusing to pay benefits.
In D.C., workers’ compensation benefits can be paid without a formal award when the insurance company accepts the claim. But when the insurance company disputes the claim, you may need to take additional steps to get the benefits you are entitled to.
What Happens After a Workers’ Comp Claim Is Denied?
If your D.C. workers’ compensation claim was denied, that does not necessarily mean your case is over. Attorney Frank Kearney explains what a denial means, what can happen next, and the options you may have to keep your case moving.
How Do You Fight a Denied Workers’ Comp Claim in D.C.?
If your claim is denied, the dispute may be handled through an informal conference or a formal hearing.
An informal conference is a less formal way to try to resolve the dispute. There is no sworn testimony like there would be at a formal hearing. A claims examiner reviews the issues and can issue a recommendation.
The problem is that an informal recommendation does not always end the dispute. If the insurance company continues to fight the claim, the case may still have to move to a formal hearing.
Because of that, there are cases where our attorneys prefer to move directly toward a formal hearing rather than spending additional time on the informal process.
Why Would We Go Straight to a Formal Hearing?
If you are injured, cannot work, and are not receiving wage benefits, time matters.
A formal hearing gives you the opportunity to present evidence before an Administrative Law Judge. After the hearing, the judge issues a Compensation Order deciding the disputed issues.
Unlike an informal recommendation, a Compensation Order can require the insurance company to pay benefits if you win your case. The insurance company may appeal the decision, but filing an appeal generally does not automatically stop a Compensation Order from taking effect unless a stay is granted.
Every workers’ compensation case is different. Whether it makes sense to start with an informal conference or move toward a formal hearing depends on why your claim was denied, your medical evidence, your work status, and the other facts of your case.
What Should You Do After Your Workers’ Comp Claim Is Denied?
A denial does not necessarily mean your case is over.
If you were seriously injured at work and the insurance company denied your claim, stopped your checks, or refused to approve medical treatment, talk with Attorney Frank Kearney and our team about what happened.
Tell us what happened and find out what your next step may be. You can also call 202-393-3320.
Related Articles:
The D.C. Workers’ Compensation Process in 5 Steps
Get Help Before Problems With Your D.C. Workers’ Compensation Case Get Worse
How Do I Choose a Workers’ Compensation Lawyer in Washington, D.C.?