A Notice of Controversion is the insurance company\u2019s formal notice that they are refusing to accept your DC workers compensation claim. Instead of paying benefits voluntarily, the insurer uses this form to say they disagree with your injury, your medical treatment, or your right to wage replacement. Until a judge issues a Compensation Order, they are not required to pay.<\/p>\n
Insurance companies file a Notice of Controversion when they believe there is a reason to challenge your case. They may question how the injury happened, whether it is work related, or whether the medical treatment is necessary. The notice allows them to officially pause the claim until the dispute is resolved.<\/p>\n
Once the notice is filed, the insurance company can stop any voluntary payments and refuse to authorize medical treatment. It does not mean you do not have a valid claim. It means the insurer wants you to prove the injury and your entitlement to benefits through the DC Office of Workers Compensation.<\/p>\n
To move your claim forward you must request help from the DC Office of Workers Compensation. You can choose either an informal meeting or a formal hearing.<\/p>\n
This is a quick meeting where a claims examiner reviews the issue and issues a written recommendation. It is not binding, but it can clarify evidence needs or help move the case forward.<\/p>\n
This is where your case is decided. The judge reviews medical records, testimony, and evidence. If the judge rules in your favor, the insurance company must pay benefits. Even during an appeal, they must continue payments. A hearing also forces the insurance company to disclose information and stops delay tactics.<\/p>\n
Your claim will not move forward on its own. Ignoring a Notice of Controversion allows the denial to stand. You risk losing medical treatment, wage benefits, and the ability to build evidence you need. Many injured workers lose their benefits because they waited too long to respond.<\/p>\n
Check out this video from Frank where he breaks down the steps you need to take.<\/p>\n