How to Appeal a Denied Workers' Compensation Claim in Maryland
Appealing a Denied Workers’ Compensation Claim
If you are a worker who is injured in a workplace accident or becomes injured or ill through your job, you may be entitled to workers’ compensation benefits from your employer or its workers’ compensation insurer. Unfortunately, your employer or its insurer may try to deny your claim or pay you less than you deserve.
When your worker’s compensation claim has been denied or undervalued by your employer or its insurer, you have a right to file a claim with the Maryland Workers’ Compensation Commission to have a commissioner make a determination as to whether you are entitled to workers’ compensation benefits.
The workers’ compensation commissioner may also deny your claim after determining that your injury or illness is not compensable or that the initial award was in the right amount. The important thing to remember is that there is usually an avenue to appeal a workers’ compensation claim.
Below is a discussion of the reasons why workers’ compensation claims are denied and the steps for appealing of a workers’ compensation claim.
Common Reasons for Denial of Workers’ Compensation Claims in Maryland and D.C.
There are a number of reasons why your employer or its workers’ compensation insurer, or a workers’ compensation commissioner, may deny your claim for workers’ compensation benefits.
Some of the most common reasons why injured workers have their workers’ compensation claims denied include:
- They failed to file a workers’ compensation claim with their employer or with the Workers’ Compensation Commission by the required date.
- The employer or its workers’ compensation insurer determines that the worker’s injury or illness is not work-related.
- There is a clerical or procedural error on the claim forms submitted to the Workers’ Compensation Commission that causes the commissioner to deny the claim on procedural grounds.
- Your employer alleges that you intentionally injured yourself or intentionally caused the accident that led to your injury.
- Your employer alleges that you were under the influence of alcohol or drugs at the time of your accident.
- Your employer, its workers’ compensation insurer, or a workers’ compensation commissioner concludes that you were not injured in the accident or that you have reached maximum medical improvement from your injury and no further benefits are due to you.
A workers’ compensation claim is often denied because a worker tries to pursue the claim on their own and makes mistakes on their claim form that cause the claim to be denied. This is why it is critical for an injured worker pursuing a workers’ compensation claim to have the assistance of an experienced workers’ compensation attorney who can ensure their claim form is properly completed.
Steps for Appealing a Workers’ Compensation Denied Claim
If your employer or its insurer denies your initial claim for workers’ compensation benefits, your first step in appealing the denied claim is to submit a claim form to the Maryland Workers’ Compensation Commission.
The commission will provide your employer with notice of your claim and an opportunity to object. If your employer objects to your claim, you will receive a notice of dispute from the commission indicating your claim has been denied in whole or in part.
If you receive a notice of dispute, you have the right to request a hearing before a workers’ compensation commissioner. You can request a hearing by timely submitting an issues form to the commission, setting forth the issue or issues you believe were wrongly decided by the commission, such as a denial that your injury or illness was work-related or a miscalculation of your average weekly wage.
The commission will schedule a hearing before a commission, who will conduct a trial in which both you and your employer or its insurer will be entitled to present arguments and evidence.
If the commissioner denies your claim, you may request reconsideration or a rehearing. The commissioner will decide whether to grant a rehearing, which in practice is rarely granted. Rehearings are typically only granted when a claimant has new evidence that couldn’t be obtained prior to the initial hearing or identifies evidence presented at the initial hearing that was not considered by the commissioner or identified an error of law made by the commissioner.
In addition to or as an alternative to a request for rehearing, you may also appeal a commissioner’s denial by filing a notice of appeal in the circuit court. If you file both a request for rehearing and a court complaint and the court rules first, the court’s ruling takes precedence. If the court rules against you, you have a right of appeal to the Maryland appellate courts.
How a Workers’ Compensation Attorney Can Help with Your Appeal
If you’ve been denied workers’ compensation benefits by your employer or its workers’ compensation insurer or by a workers’ compensation commissioner, an attorney can be critical for seeking to have the denial reversed and helping you pursue the benefits you need and deserve.
A workers’ compensation appeals attorney can help you with your appeal by ensuring that your claim is timely filed with your employer or its insurer, or if your claim is denied by your employer or its insurer, with the Maryland Workers’ Compensation Commission.
If the commission issues a notice of dispute, a workers’ compensation attorney can help you prepare a strong, persuasive case to make to the workers’ compensation commissioner in order to seek the benefits you have been wrongly denied.
If a hearing before a commissioner results in a continued denial of benefits, a workers’ compensation attorney can advise you as to the best strategy to appeal the denial of you claim, whether that be to file a request for rehearing, a notice of appeal to the circuit court, or both. If you must take your workers’ compensation claim to court, a workers’ compensation attorney can vigorously advocate on your behalf for the benefits you deserve.
If you’ve suffered a work-related injury or illness, don’t wait another day to begin pursuing the workers’ compensation benefits you deserve. Contact the Maryland workers’ compensation attorney at Trollinger Law LLC today to schedule a free consultation about your legal rights and options and how our workers’ compensation attorney can help you appeal the denial of your claim.