Imagine this: you’ve been injured at work, and you’re counting on workers’ compensation to help you through. Then, you receive a letter from the Washington State Department of Labor & Industries (L&I) saying they have denied your claim for benefits. It’s a gut-wrenching moment. But don’t lose hope. You have options to appeal this decision.
Why claims get denied
Insurance companies deny claims for various reasons. Some of the more common reasons why L&I may not approve a claim include:
- Missing deadlines for reporting the injury
- Lack of medical evidence
- Disputes about whether the injury is work-related
- Incomplete paperwork
Understanding the reason for the denial is the first step in fighting back. If you believe your decision was wrong, you can file an appeal. This step is essential if you want to secure the benefits you deserve.
The appeal process
You have the right to appeal L&I’s decision. To start the appeal, you must file a written protest within 60 days of receiving the denial letter. You can file your appeal online or by mail.
After you file, your case goes to the Board of Industrial Insurance Appeals (BIIA). The BIIA is an independent agency that reviews L&I decisions.
L&I has an opportunity to reconsider its decision, but if it chooses not to, the BIIA will schedule a hearing where you can present your case. You can present evidence, call witnesses and explain why you disagree with L&I’s decision. The BIIA will then make a ruling, which could modify, reverse or uphold L&I’s decision.
How a lawyer can help
An experienced workers’ compensation attorney can help you through the appeal process. They can:
- Help you gather and present evidence to strengthen your case
- Represent you at hearings and depositions
- Ensure you meet all deadlines and requirements
- Negotiate with the insurance company on your behalf.
You don’t have to figure out the appeal process alone. With legal guidance, you can improve your chances of a successful outcome.
A denied workers’ compensation claim is not the end of the road. By understanding the appeal process and seeking professional help, you can fight for the benefits you deserve.