Experienced Dothan attorneys guide you through the appeal process
Workers’ compensation benefits are an important part of our social safety net. Without insurance to cover medical bills and at least partial wage replacement, workers would face extreme financial hardship any time they got hurt or sick on the job. Workers’ compensation is supposed to take the worry out of recovering the necessary reimbursements, but too often injured workers are denied benefits despite claims that are legitimate on their face. If you have received a notification of denial of your claim, it’s time to speak to a workers’ compensation attorney. In Alabama, Carey & Hamner, P.C. provides skilled and determined representation for workers’ compensation appeals. We understand how heavily you rely on your benefits and we work tirelessly to deliver the results you deserve.
Why would a workers’ compensation claim be denied?
Although you have taken all the proper steps — such as notifying your employer promptly and seeing an approved physician — you may receive a notice from the Alabama Department of Labor’s Workers’ Compensation Division that your claim has been denied. Common reasons for denying claims for include:
- Finding the injury was not work-related — An injury must take place during work and “arise out of” the worker’s employment. Generally, you have to prove that you were hurt while doing something that confers a benefit on the employer.
- Delay in reporting to your employer — You should alert your employer about the accident as soon as possible and certainly within 90 days.
- The medical care was not reasonable or necessary — The employer is responsible only for medical treatment related to your workplace accident or occupational illness. Extreme or experimental therapies are not covered. When in doubt, seek prior approval for the treatment you want to undergo.
- The treating physician was not approved — Except for emergency care, you must see a doctor on your employer’s list of approved healthcare providers. You cannot see your own physician without the expressed approval of your employer or the insurer.
- Your medical records do not support your claim for benefits — If the records you submit don’t clearly indicate you are unable to work, an employer can put a hold on your disability benefits.
If you have received a notice of a claim denial, you should immediately contact a workers’ compensation attorney at our firm.
Dealing with a workers’ compensation claim denial in Alabama
While other states have a single workers’ compensation board that handles all appeals, Alabama has two separate tracks for dealing with claims denials. If your dispute is over treatment options or medical bills, you can contact the Alabama Department of Industrial Relations. Through the department’s Ombudsman Program, a mediator can hold a conference between the parties and work towards a negotiated solution.
The Department of Industrial Relations only manages appeals in treatment cases. For all other issues, such as disability payment disputes, your remedy is to file a lawsuit in state court. Generally, the statute of limitations allows two years from the date of your workplace injury or the onset of occupational illness to file a lawsuit. However, if the insurer paid you some disability benefits, the two-year period begins on the date of your last payment.
In view of the complexity of the Alabama appeals system, you should only entrust your case to an experienced attorney who understands the process and is able to investigate, compile the required evidence and build a compelling case for overturning a claim denial.
Contact our Alabama law firm for assistance with workers’ compensation appeals
Carey & Hamner, P.C. in Dothan helps clients appeal denials of their workers’ compensation claims. To schedule a consultation, call 855-435-4797 or contact us online. Our office is located across Main Street from the First United Methodist Church.