At Disability Attorneys of Arizona, we have extensive experience handling workers’ compensation appeals. If your workers’ comp claim has been denied or you are dissatisfied with the benefit amount, you may be wondering about the next steps. Although you have a right to file an appeal, the process can be long and complicated.
The best way to protect your rights is to have an experienced workers’ compensation attorney at your side. Knowing that a workplace injury or illness can impact not only your well-being but also your finances, we will fight to help you obtain the benefits you deserve. Contact our Phoenix office today to get started.
The Workers’ Compensation Appeals Process in Arizona
The first step in the worker’s comp appeals process is to request a hearing with the Industrial Commission of Arizona (ICA) within 90 days of receiving your denial notice. After you file your request, the ICA will notify you of the date and time of the hearing — generally within 3 months of the request. Our legal team is here to guide you through all aspects of the appeals process, including:
Prehearing Conference
The administrative law judge (ALJ) assigned to your case may require the parties to attend a prehearing conference. This conference gives the ALJ an opportunity to discuss the case with both parties and it is typically conducted by phone. Participation in the conference is mandatory and failure to attend may result in denied benefits.
Discovery
The discovery process involves an exchange of information related to the case. This includes medical records prepared by any doctors who may have treated you as well as other relevant information. You may also be required to give a deposition to the insurance carrier’s attorney
Hearing
During the hearing, you will be asked to testify first, and the ALJ will question you, and any witnesses that you or your employer have called, about your claim. The insurance company’s attorney will also cross-examine you, so it is crucial to be prepared. Our workers’ comp appeals attorney will work with you to review all the evidence, including medical records and notes from witnesses, to present a compelling case.
The ALJ’s Decision
A decision about your appeal will be made within 30 to 60 days of your hearing. The judge may reverse the initial determination; however, if your appeal is denied, don’t give up hope. You can request a review within 30 days, and the ALJ will reconsider the case and issue a final decision.
If the judge denies your claim, we may consider filing an appeal with the Arizona Court of Appeals if doing so is in your best interests.
Why Arizona Workers’ Compensation Claims Are Denied
Although you are entitled to workers’ compensation benefits if you sustain an injury or illness on the job, claims may be denied for several reasons:
- Failing to notify your employer — You are required to notify your employer about a workplace injury as soon as reasonably possible after it occurs, and your employer must then report the injury to the ICA. If you fail to notify your employer in a timely fashion, your claim will likely be denied.
- Failing to meet the deadline — A workers’ compensation claim must be filed with the ICA within 1 year of the date of your injury or illness. Your claim will be denied if it is not filed within this time period, or it is incomplete or inaccurate.
- The injury was not work-related — Your injury must have occurred in the course of performing work-related duties, while on the employer’s premises, or within the scope of your employment.
- The claim is disputed — Your employer may argue that your injury was not work-related or the workers’ compensation insurance carrier may claim that your illness or injury was a pre-existing condition.
In addition, your workers’ compensation claim may be denied if:
- The medical evidence does not support your claim
- You failed to promptly seek medical attention
- You received medical care from an unauthorized health care provider
- A blood test shows drug or alcohol use at the time of the injury
While these may be valid reasons for a claim denial, there may be other factors involved. First, your employer may contest the claim to prevent premiums from being raised. Also, insurance companies often put profits ahead of injured workers and attempt to deny or delay valid claims.
Regardless of the reasons your claim is denied, our workers’ compensation attorneys have the skills to handle the appeals process and the determination to win you the benefits you deserve.
Contact Our Experienced Arizona Workers’ Compensation Appeals Attorneys
If your worker’s comp claim has been denied, turn to Disability Attorneys of Arizona. We have a proven history of achieving positive outcomes and will work closely with you to collect the necessary medical evidence and witness statements.
Our legal team has in-depth knowledge of the ICA’s rules governing workers’ compensation and will make sure your rights are protected. We offer free consultations and there is never a fee until we win benefits for you. Contact us today for a consultation.