When an insurance company denies your workers’ compensation claim, you may be wondering what your options are. A Springfield workers’ compensation appeals lawyer from our firm could help you challenge that decision and pursue the benefits you are entitled to receive.
At Pellegrini, Seeley, Ryan & Blakesley, P.C., we are committed to helping injured workers pursue the benefits they need. Our attorneys could handle your appeal, protect your rights, and present a strong claim for compensation. We have nearly 70 years of experience, and we handle more workers’ compensation cases than any other firm in Worcester and West Massachusetts.
You could file a workers’ compensation appeal if your employer’s insurance provider denies your claim, refuses to fairly pay you fairly, or discontinues your benefits. You could also appeal if more than 30 days have passed since you notified your employer about your injury or illness and the insurer has not filed your claim.
To initiate an appeal, you will need to file an Employee’s Claim Form (Form 110) with the Department of Industrial Accidents (DIA). Along with this form, you will need to submit medical evidence of your injury and documentation proving that your condition is work-related, such as eyewitness statements or workplace accident reports.
It is a good idea to consult a lawyer before filing because the appeals process can be complex. Our attorneys handle workers’ compensation appeals in Springfield and could help you with your case.
Appealing a denied workers’ compensation claim involves multiple stages, but our attorneys in Springfield could represent you throughout the entire process.
Conciliation is an informal meeting between you and the insurance company to see whether you can resolve the dispute. You can, and should, have a lawyer present during this meeting. If you do not reach a voluntary agreement, the denial remains, and the DIA schedules the case for conference.
A conference is an informal hearing before an Administrative Law Judge (ALJ). During the conference, you and the insurance company can present your arguments and submit evidence, such as medical records, but you cannot call witnesses.
The ALJ will issue a conference order approving or denying your claim. Either party can appeal this decision within 14 days.
You can try to resolve your claim through mediation before the case proceeds to a formal hearing. If both parties agree, a different judge conducts the mediation than the one who handled the conference. If you and the insurance company reach an agreement, the claim is closed. If not, it advances to a hearing.
The hearing is a formal legal proceeding before the judge who conducted the conference. Our attorneys could present evidence and call and examine witnesses to support your claim. At the conclusion of the hearing, the ALJ will issue a hearing decision.
You can appeal the judge’s decision to the Review Board, which is made up of six ALJs. However, you can only appeal on the grounds that the hearing judge made an error of law. Proving such an error can be difficult and requires in-depth knowledge of the workers’ compensation system.
If either you or the insurance company appeals the Review Board’s decision, the case proceeds to the Court of Appeals.
You do not have to stop pursuing workers’ compensation after an insurance company denies your claim or discontinues payments. If you were injured while working, a Springfield workers’ compensation appeals lawyer from our firm could help you seek the medical coverage and wage replacement compensation you deserve. Contact us today for a free consultation.
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