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How To Appeal A Denied Workers’ Comp Claim In Indiana

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If your employer or the insurance company that handles your employer’s workers’ compensation benefits denies your claim, you may be worried understandably about your family finances and your future. If your injury is serious, you may be unable to work again or have limitations on the type of work you can do. If you are an injured worker and your claim has been denied, you have a right in Indiana to appeal the decision. You should not give up. We have helped many workers appeal and obtain benefits after their claims were initially denied.  But you don’t want another rejection letter, so you should seek dependable legal guidance to proceed. You should schedule a free consultation with a knowledgeable workers’ compensation attorney to discuss the best way to move forward.

Indianapolis workers; compensation attorneys Randy Klezmer and Nathan Maudlin represent injured workers who are having trouble obtaining benefits. We offer help to injured employees with disputed worker’s compensation claims and appeals. From handling thousands of cases, Klezmer Maudlin PC has developed a thorough understanding of Indiana workers’ compensation law and what it takes to appeal a denied claim successfully. Because of our extensive experience handling workers’ comp claims, we wrote the Indiana Workers’ Compensation Law and Practice manual, a legal reference book that other attorneys turn to for guidance.

Every workplace accident has unique factors to evaluate. Our Indianapolis workmen’s comp lawyers are available to review the details of your job-related injury or occupational disease and address your specific questions about appealing a denied claim. Contact Klezmer Maudlin PC to schedule a free consultation to discuss your case.

What to Do if My Workers’ Comp Claim Has been Denied?

If your workers’ compensation claim has been denied by your employer, you have a legal right in Indiana to appeal that decision. There are several stages of appeals. To start the process, you must fill out a Form 29109 called an Application for Adjustment of Claimand file it with the Indiana Workers’ Compensation Board.

The Workers’ Compensation Board hears workmans comp claim appeals. Under Indiana law, you have two years from the date of your injury to file an Application for Adjustment of Claim with the Board. The Ombudsman division of the Indiana Workers’ Compensation Board may be able to resolve a disagreement between you and your employer through a dispute resolution process.

If the dispute about your denied workers compensation claim cannot be resolved informally, it is assigned to one member of the Indiana Workers’ Compensation Board who will act as a judge. The judge will hold a hearing, consider the evidence in your case and make a decision about all unresolved issues. It is your responsibility as an injured worker to gather and properly introduce evidence to support your appeal and prove that you are entitled to benefits. The hearing is a legal proceeding. It is a good idea to have a knowledgeable workers’ compensation attorney represent you.

How to File a Workers’ Comp Claim Appeal in Indiana

If you disagree with the single hearing judge’s decision or the amount of benefits awarded you, you have a right to appeal the single judge’s decision. To do so, you file an Application for Review by the Full Board asking the seven-member Workers’ Compensation Board to review the case. This appeal must be filed within 30 days of the date of the single judge’s decision. The hearing before the full board is not a new hearing. Rather, this appeal involves legal arguments before the full Workers’ Compensation Board based on the evidence previously introduced before the Single Hearing Judge. The full board usually hears appeals within three months. If you are dissatisfied with the final decision of the Indiana Workers’ Compensation Board, you have a right to file an additional appeal with the Indiana Court of Appeals, and then the Supreme Court of Indiana.

It is a good idea to seek the help of a knowledgeable Indianapolis workers’ compensation attorney at the start of the appeals process to assemble evidence and build the strongest case for you to secure benefits. You will be at a disadvantage if you do not have an attorney representing you who understands workmans comp law.

Your employer or the employer’s insurance provider will have a lawyer representing their interests during the appeals process. You should have an attorney standing up aggressively for you too.

Can an Indianapolis Workmens Compensation Lawyer Help Me?

As an injured worker, you have the burden to prove every fact necessary to appeal a denied claim and secure benefits. You have a right to consult with an attorney at any point in the process. It is a good idea to turn to an experienced attorney for advice as soon as possible. The presentation of a workers’ compensation case will involve technical provisions of Indiana law, rules of evidence and rules applying to the exchange of medical information. If you fail to understand and follow the rules, it would cause you to lose your case.

A knowledgeable workers’ compensation attorney can guide you through the complicated administrative appeals process and keep track of the statutes of limitation that must be met to avoid having a claim rejected.

You have two years to file an Application for Adjustment with the Workers’ Compensation Board. With some workplace injuries or occupational diseases, it can be complicated to calculate when the injury occurred and the clock started ticking on the two-year filing period. We will keep track of the documentation and the deadlines.

An attorney at Klezmer Maudlin, PC can file an Application for Adjustment with the Indiana Workers’ Compensation Board and make sure all filing deadlines are met. For instance, you have only 30 days to file an appeal asking for the full Workers’ Compensation Board to hear your appeal if you are dissatisfied with the award made by the judge. Our attorneys will represent you in the hearing before the judge who is assigned to your case and in subsequent hearings.

Can a Workers’ Comp Lawyer Handle My Appeal?

An experienced attorney can help you gather the medical evidence to make the strongest case for workmans comp benefits and ensure that it is properly introduced. Our lawyers have a good understanding of the types of medical evidence that the Workers’ Compensation Board is seeking to have a successful appeal.

We can help prevent a misstep, which can jeopardize your appeal. For example, if you represent yourself at the hearing before the judge from the Workers’ Compensation Board, you may fail to introduce crucial medical evidence and really damage your chances of obtaining benefits. An attorney representing you may be unable to use certain evidence on appeal because you failed to introduce it during the initial hearing.

Having an experienced workmens compensation attorney advocating on your behalf throughout the appeals process can ease your burden and allow you to focus on your recovery. While you are entitled to represent yourself, the chairman of the Workers’ Compensation Board has said that experience shows that representing yourself may not be the best choice for an injured worker.

Workmans Comp Insurance

Employers are required by law in Indiana to carry workmans comp insurance and provide benefits to injured full and part-time employees. Workmans comp benefits include:

  • coverage of all reasonable medical expenses associated with your injury
  • temporary income to cover a portion of your lost wages while you cannot work
  • compensation if you lose the use of a body part as a consequence of a workplace injury
  • death benefits to the dependents of an employee killed in a work-related accident.

Employers in Indiana have a right to deny workmans comp claims in certain situations such as deliberate misconduct on the part of the worker or knowingly failing to use safety equipment. Indiana law requires your employer or the worker’s compensation insurance provider to send a Report of Claim Status (Form 38911) listing a reason for the denial of your claim. As an injured worker, you then have a legal right to appeal the denial. That is where our legal experience can make a difference.

Injured workers have a legal right to a hearing before the Indiana Workers’ Compensation Board if an employer has denied the worker’s claim for benefits. Our attorneys can gather evidence to support your appeal and represent you at hearings before the Indiana Worker’s Compensation Board.

Proving Employer is at Fault for Injuries

You do NOT have to prove your employer or a co-worker was at fault to obtain worker’s compensation benefits. Workers’ compensation insurance is similar to no fault insurance. It pays benefits regardless of fault, unless the injury resulted because of the worker’s own misconduct such as not wearing safety equipment or being intoxicated on the job.

As an injured employee in Indiana, you are entitled to workers’ compensation benefits regardless of who caused the workplace accident. You may receive workmans comp benefits even if you were at fault, as long as you did not injure yourself through intentional misconduct such as being intoxicated on the job.

In exchange for receiving paid medical care and other workers’ compensation benefits, injured workers generally are not permitted to sue their employers for injuries that occur on the job.

Fault may be a consideration if someone other than your employer or your co-worker caused your injury. Filing a lawsuit and proving a third party was at fault may entitle you to other types of compensation.

Recover Compensation for Medical Bills and Pain and Suffering

You may be entitled to file a personal injury lawsuit against a third party that caused your injury in addition to collecting workers’ compensation benefits. For example, if you are a construction worker employed by a subcontractor at a construction site and the general contractor fails to correct hazardous conditions that cause your injury, you may be entitled to file a lawsuit against the general contractor. In this example, you would need to prove that the general contractor was at fault and the contractor’s negligence caused your injury.

Our experienced attorneys at Klezmer Maudlin, PC can review the specific details of how your workplace accident occurred and explain your legal options and whether a third-party claim is appropriate in your case.

Third-party lawsuits are appropriate after some, but not all, workplace accidents. When appropriate, an injured worker may be entitled to seek compensation through a third-party lawsuit against a potentially liable other party for the following:

  • medical bills and rehabilitation expenses;
  • lost wages;
  • future lost wages if you cannot return to work or have future limitations;
  • pain and suffering.

How Much Does a Workers’ Compensation Lawyer Charge to Handle an Appeal?

At Klezmer Maudlin, PC, our lawyers handle workers’ compensation cases on a contingent fee basis. Our legal fee comes out of any compensation that we obtain for you. The Indiana Workers’ Compensation Board sets the amounts that attorneys who represent injured workers can charge for legal representation. It is generally a percentage of the amount awarded to the injured worker.

In addition, the injured worker is responsible for the payment of expenses for medical reports and depositions.

Contact an Indiana Workmans Comp Lawyer Today

If your company has rejected your request for workmans compensation benefits after an on-the-job accident, you should not accept their denial as the final word. You should seek a free consultation with a knowledgeable workers’ compensation attorney. You owe it to yourself and your family to understand your legal rights and whether you have a basis to appeal the denial. The attorneys at Klezmer Maudlin, PC are committed to assisting injured Hoosier workers obtain the benefits to move forward with their lives after serious workplace injuries. We offer a free consultation to discuss the specifics of your injury and your rights to appeal a denied claim.

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