How to Appeal a Workers’ Compensation Denial in Indiana


An injury on the job can devastate you, not only physically but also emotionally and financially.

As an injured worker in Indiana, you can seek workers’ compensation benefits to cover your medical expenses and lost wages while you recover. However, what happens when your workers’ comp claim is denied?

An experienced Indiana workers’ compensation attorney can navigate the appeals process and fight for the benefits you deserve.

The denial of your claim can feel like a crushing blow, leaving you helpless and unsure of what to do next. You may be worried about how you will pay your bills and support your family while you cannot work. It’s important to know that you have options.

Understanding the Reasons for a Workers’ Comp Claim Denial

Before we delve into the appeals process, it helps to understand some of the common reasons why workers’ comp claims are denied in Indiana.

A man holding a card with the text "Claim Denied."

These reasons may include:

  • Your employer disputes that your injury occurred at work or is work-related.
  • You failed to report your injury to your employer within the required timeframe (30 days).
  • You did not seek medical treatment or follow your doctor’s orders.
  • Your injury is not covered under Indiana’s workers’ compensation laws.
  • There is insufficient evidence to support your claim. 

If workers’ comp denies your claim, the first step is to carefully review the denial letter with your lawyer to understand the specific reason for the denial. This information will help you determine your next steps and provide insight into building a strong case for your appeal. 

A lawyer with focused experience handling workers’ comp claims in Indiana will know the specific laws that govern workers’ comp cases in this state.

The Appeals Process for Indiana Workers’ Comp Claims

In Indiana, you can appeal the decision if workers’ comp claim denies your claim. With the help of an experienced workers’ comp attorney, you can increase your chances of success.

Here are the steps involved in the appeals process:

  • File an Application for Adjustment of Claim: The first step in the appeals process is to file an Application for Adjustment of Claim with the Indiana Workers’ Compensation Board. This form must be filed within two years of your injury or the last date you received workers’ comp benefits. Your attorney can help you complete and file this form.
  • Attend a Hearing: After you file your application, a hearing will be scheduled before a workers’ compensation board member. At the hearing, you and your employer (or their insurance carrier) can present evidence and argue your case. Your attorney will represent you at the hearing and present evidence to support your claim, such as medical records, witness testimony, and expert opinions.
  • Receive a Decision: After the hearing, the board member will issue a written decision either approving or denying your claim. If your claim is approved, you will start receiving benefits.
  • Appeal to the Full Board: If you disagree with the board member’s decision, you can file an appeal with the full Workers’ Compensation Board. The full board will review the evidence and hearing transcript and decide. If you disagree with the full board’s decision, you can appeal to the Indiana Court of Appeals.

The Unique Role of the IME in Indiana and How It May Affect Your Appeal

In Indiana, the Independent Medical Exam (IME) plays a unique role in workers’ comp cases. Unlike in many other states, where the IME determines maximum medical improvement, Indiana uses what the state refers to as an IME to either obtain a second opinion or when a judge orders one.

If you decide to get a second opinion through an IME, or if the judge orders one, the workers’ comp board will appoint the doctor. This creates a more independent system than in most states, where the insurance company often chooses the IME doctor.

The IME can play a significant role in your appeal. If the IME doctor’s opinion supports your claim, it can strengthen your case and increase your chances of success. Your attorney can use the IME results as evidence at your hearing or appeal.

The IME process in Indiana differs from what IME typically means in other states and workers’ comp cases. Your attorney can explain the IME process and help you understand how it may affect your case.

How Can an Indiana Workers’ Compensation Lawyer Help Your Appeal?

Damage Compensation Concept: Labor and Construction Law.

Your Indiana workers’ comp attorney will work to gather all the necessary evidence to support your claim, including medical records, witness statements, and expert opinions. They will build a strong case on your behalf and compellingly present the evidence at your hearing. 

The workers’ comp appeals process can be confusing and overwhelming, especially if you are unfamiliar with the legal system. Your lawyer will handle all the legal aspects of your case, from filing paperwork to representing you at hearings and appeals. They will meet all deadlines and protect your rights throughout the process. 

Sometimes, you may negotiate a settlement with the insurance company before going through the appeals process. Your attorney can negotiate on your behalf to try to reach a fair settlement that covers your medical expenses and lost wages. 

If your case goes to a hearing or appeal, your attorney will be by your side to represent you and argue your case. They will present evidence, cross-examine witnesses, and make legal arguments to support your claim.

Find an Experienced Indiana Workers’ Comp Attorney

Dealing with a workers’ comp denial can be frustrating and overwhelming, but it’s important to remember that you have rights and options. Don’t let a workers’ comp denial discourage you from seeking the benefits you need to recover from your work-related injury. 

By understanding the appeals process and working with an experienced Indiana workers’ comp lawyer, you can fight for the benefits you deserve. Arrange a free consultation to discuss your case and learn more about your options for appealing a denial. With the right legal guidance and support, you can get the benefits you need to focus on your recovery and move forward with your life. 

Call our Indianapolis office at (317) 569-9644  to connect with a skilled attorney, or fill out the contact form on this website.

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