Greensboro Workers' Comp Claim Denials & Appeals

You got hurt at work, and you filed a workers’ compensation claim. Then you got the news that the workers’ compensation carrier denied your claim. Now what?

With the help of the experienced team at Hardison & Cochran | Injury & Workers Comp Lawyers, you can file a workers’ comp claim denial appeal. When you call our office, we’ll listen to your story and advise you on how we can appeal your claim denial. Your initial consultation is free. Contact our Greensboro workers’ compensation attorneys today and let us get to work on your claim to seek the benefits you deserve.

Common Reasons Workers’ Compensation Claims Are Denied in Greensboro

Your Greensboro workers’ compensation case may have been denied for a variety of reasons. The most common issues cited for denied claims include:

• The injury wasn’t reported within 30 days. If the employer didn’t receive a written notice of your injury within 30 days, they may claim your injury isn’t work-related.
• The claim wasn’t filed within two years. If you wait more than two years from the date of injury to file your claim, you may not be entitled to benefits.
• The accident didn’t occur at work. This is especially true for soft tissue injuries like back sprains or shoulder strains, or if the injury occurred on a Monday.
• There isn’t enough evidence tying your injury to your job. You need detailed medical records establishing how your work caused your injury.
• Your employer classified you as an independent contractor. Because independent contractors are not entitled to workers’ compensation benefits, many employers misclassify employees.
• Your injury is attributed to a pre-existing condition, not a work accident. The insurance company may try to argue that a pre-existing condition caused or contributed to your workplace injury or illness.

While your employer and their insurance company may make many arguments to deny your claim, they may not always be valid. Our experienced workers’ compensation lawyers can help you assert your rights and fight against any unjust denials.

Understanding Form 61: What a Claim Denial Means for Your Case

When your employer denies your claim, they are required to submit Form 61 to the North Carolina Industrial Commission (NCIC) and send a copy to you and your attorney. The employer must detail the reasons for the denial in the form. That reasoning is crucial to determining the weaknesses in your claim and how to challenge their denial.

If you receive a Form 61, you have the right to appeal your employer’s denial of your claim.

The North Carolina Workers’ Compensation Appeals Process

You may ask, “How do I appeal a workers’ comp denial?”

You begin by filing Form 33 with the North Carolina Industrial Commission. Filing this form starts the workers’ comp appeal process. This lets the Industrial Commission know that you want a hearing because of a dispute in your case. The Commission will assign a deputy commissioner to your case and give you a hearing date.

From there, the workers’ compensation claim process looks like this:

• Attempt mediation: You, your attorney, and the workers’ comp insurer may attend mediation in an attempt to reach an agreement. In mediation, a neutral third party facilitates negotiations. The mediator can suggest ways to reach a compromise, but they do not make decisions for the parties. If mediation is unsuccessful, a hearing is the next step.
• Prepare for hearing: Before the hearing, you or your lawyer will assemble the evidence you’ve accumulated that supports your claim. The evidence may include witness statements from others who saw the accident happen, medical records that connect your injury to your work tasks, and testimony from medical, vocational, or economic experts.
• Present case at hearing: On the hearing date, you, your attorney, and your employer’s insurance company’s attorney will appear before the deputy commissioner. The deputy commissioner will hear both sides’ arguments, review the evidence presented, listen to witnesses, and decide the outcome of your hearing.
• File further appeals: If the deputy commissioner still does not approve your claim, you can appeal your case before the full commission. There are then additional opportunities to appeal through the state court system.

If your employer denied your claim, you should contact an experienced workers’ compensation attorney to handle your appeal. An attorney can investigate your case, obtain the evidence required to support your claim, and create a strategy for presenting a strong argument.

Preparing for Your Workers’ Comp Hearing Before the Industrial Commission

During a workers’ comp hearing, you will need to testify under oath. This can naturally feel intimidating, especially when so much is at stake. It’s crucial to feel well prepared before entering the hearing so that you can present the best case possible.

To help prepare for your workers’ comp hearing, you should:

• Collect substantial evidence: You and your lawyer must gather the evidence required to challenge the denial’s arguments. That may include a copy of the written report of injury you submitted to your employer, your medical records, a doctor’s expert opinion that your injury occurred at work, and notes about what any witnesses who will testify will say.
• Develop your argument: Once the evidence is gathered, you’ll need to build a compelling story connecting your injuries to your job that you can support with evidence at every step. The presentation you make before the deputy commissioner must address the insurance company’s reason for denial.
• Practice your testimony: Your lawyer can review the testimony you will give ahead of time with you so that you feel comfortable telling your story. You can also be sure that what you say in the hearing about how the accident occurred is consistent with the information you provided to your treating physician and the employer.

At the hearing, stay calm, take deep breaths before you answer each question, and be honest.

How to Strengthen a Denied Workers’ Compensation Claim in Greensboro, NC

The best way to strengthen your case is to review the denial letter for the specific reasons the insurer rejected your claim. You should address each point in your appeal. To do that, you and your attorney may:

• Gather additional medical records and request opinions from your treating doctors.
• Find co-workers or witnesses who saw the accident and ask whether they will testify.
• Establish when your employer knew about the injury or why you couldn’t report it.
• Collect financial documentation supporting your injury’s impact on your earning ability.
• Obtain video or surveillance footage showing how the accident happened.

The more evidence you can gather that supports your version of the way the injury occurred, the stronger your case will be.

What Happens After the Deputy Commissioner’s Decision?

The deputy commissioner will issue a written decision within several months after the hearing. If they approve your claim, you should begin receiving your benefits. However, you may still be able to file further appeals if the deputy commissioner agrees that your claim should be denied.

You have 15 days after the deputy commissioner’s decision to appeal your claim to the full commission panel. You can file Form 44 to request a review by the full commission. This appeal does not involve a new hearing. Instead, you submit a written argument. The commission then reviews the evidence and testimony from the original hearing to make their decision.

If that decision goes against you, you may appeal to the North Carolina Court of Appeals within 30 days.

Contact Hardison & Cochran | Injury & Workers Comp Lawyers to Appeal Your Denied Workers’ Comp Claim

A work injury you sustain while performing your job for your employer in North Carolina may qualify you for workers’ compensation benefits. When you’re legitimately injured at work, you deserve the benefits the North Carolina Workers’ Compensation Act allows. And when your valid claim is denied, you need help.

That’s where the Greensboro workers’ compensation lawyers at Hardison & Cochran | Injury & Workers Comp Lawyers step in. Our dedicated team has over 40 years of experience in representing injured workers. We’ve secured millions of dollars in benefits and awards in our case results for our satisfied clients over the years, including $2 million for a worker who required multiple surgeries after a large container fell from a forklift onto him.

We’re also proud of the positive feedback we’ve gotten from our clients, such as this review from our testimonials page:

“I had not been in a Worker’s Compensation situation and I had no experience or knowledge of the process. Attorney Jack Hardison and his staff not only provided me with personal attention, I honestly felt that they cared about my injury and my health. This law firm has my future business for whatever reason I may need…Thank you to everyone in this office for their concern, consideration and completion of my case. Even the final exit with my paperwork was handled with great attention.”

— L. Poole

If your claim was denied, don’t try to handle the workers’ comp appeal process on your own. We’d be honored to use our skills and knowledge to fight for the workers’ comp benefits you deserve. Call Hardison & Cochran | Injury & Workers Comp Lawyers for a free consultation to learn more.

*Each case is unique, and past results do not guarantee future outcomes.