Filing a workers’ compensation claim after suffering a workplace accident does not guarantee that you will get benefits. Your claim could hit a snag for several reasons, such as the circumstances of your accident, mistakes with the paperwork or failure to observe specific deadlines.
Fortunately, it is possible to appeal a denied claim and get the benefits due to you. Here is what you need to know about the process in Connecticut.
Where do you start?
Ideally, denied claims should be resolved by reaching an accord with the insurer and your employer. Should this not work out, one can request an Informal Hearing where an Administrative Law Judge will act as a mediator and factfinder to try and resolve the dispute.
If the outcome is unsatisfactory, it sets the stage for a Pre-formal Hearing of your appeal, which precedes the formal hearing. A Pre-formal hearing is basically meant to prepare the case by clarifying the issues at the heart of the dispute and setting the timetable for the subsequent hearing.
Afterward, the Formal Hearing proceedings will begin, presided by an Administrative Law Judge who will hear and determine the fate of your claim. The decision from the Formal Hearing can be appealed to the Commission’s Compensation Review Board within 20 days.
What are your chances of success?
Whether or not your appeal will sail through and how long it will take depends on the unique aspects of your claim.
For instance, if the denial was due to documentation errors, your appeal may go through much more easily than one where legal technicalities are involved. Either way, it is advisable to get assistance when appealing a denied claim to increase the odds of things going your way.
