February 23, 2025
Experiencing a denial of your workers' compensation claim can be a frustrating and overwhelming situation, especially when you're dealing with the aftermath of a workplace injury. Fortunately, in North Carolina, you have the right to appeal this decision. Understanding the steps to take after a denial is crucial for securing the benefits you deserve. Here’s a guide on what to do when your workers' comp claim is denied.
The first step is to carefully read the denial letter from your employer's insurance company. This document will outline the specific reasons for the denial, which could range from insufficient medical evidence to disputes about whether your injury is work-related. Understanding these reasons is essential for crafting a strong appeal.
Before proceeding with an appeal, it’s advisable to consult with an experienced workers' compensation attorney. They can help you understand your rights, evaluate the reasons for the denial, and provide guidance on how to strengthen your case. An attorney can also assist in gathering necessary evidence and documentation to support your claim.
In North Carolina, you typically have 30 days from receiving the denial notice to file an appeal with the North Carolina Industrial Commission (NCIC). This involves submitting Form 33, known as the "Request That Claim Be Assigned for Hearing." This form officially notifies the NCIC of your intent to appeal and requests a hearing before a Deputy Commissioner.
After filing your appeal, a mediation session will be scheduled between you and your employer or their insurance representative. Mediation involves discussions facilitated by a neutral third party to help resolve disputes over your workers' compensation claim. It's important to be prepared with all relevant evidence and documentation during this process.
Read: 5 Tactics Insurance Companies Use to Justify Low Offers in Personal Injury Claims
Collecting supporting evidence is crucial for a successful appeal. This may include medical records, witness statements, and any other documentation that can substantiate your claim and counter the reasons given for denial. Your attorney can help you organize this information effectively.
If mediation does not resolve your claim, you will proceed to a formal hearing before a Deputy Commissioner. During this hearing, both parties will present their evidence and arguments. It’s essential to have legal representation at this stage to ensure your case is presented effectively.
If the Deputy Commissioner rules against you, there are further avenues for appeal within the NCIC or even up to the North Carolina Court of Appeals if necessary. Each level has specific timelines and procedures that must be followed.
A denied workers' compensation claim does not mean that all hope is lost; there are clear steps you can take to fight for your benefits. Navigating this process can be complex, but having knowledgeable legal support can make a significant difference.
If you need assistance with your workers' compensation claim or have faced a denial, Hall & Dixon is here to help. Their experienced team specializes in workers' compensation cases and can provide tailored guidance to help you secure the benefits you deserve. Contact Hall & Dixon today for expert support in navigating your workers' comp issues in North Carolina.
Read: Navigating Contributory Negligence: Why Your NC Injury Claim Might Be Denied
