Workers Comp Claim Denied

Charlotte Workers’ Compensation Denial Attorneys

Helping injured workers with denials and appeals in North Carolina

When employees are injured at work, they may be able to claim benefits by filing a workers’ compensation claim. Unfortunately, valid claims are often denied for a multitude of reasons, leaving injured employees to struggle with insurmountable medical debts and other financial losses. Luckily, it is possible to appeal a denied workers’ compensation claim. If successful, you’ll receive benefits to facilitate your recuperation and recover your financial losses.

Your best chance at filing a successful appeal is to retain the services of an experienced Charlotte attorney. At Price, Petho & Associates, we have been representing workers’ compensation claims and appeals since 1979. Let our team help file an effective appeal and work to grant you the benefits you need to ensure your quality of life, now and in the future.

I reached out to Price, Petho, and Associates after I found myself in need of an attorney for an accident I was in that led to personal injury. This was my first experience with something like this and they guided me through the process every step of the way. Every question I had was answered promptly and I truly feel they had my best interest at heart. I highly recommend them if you should find yourself in need of these services. – C.P.

What would you like to know?

Workers Comp Claim Denied 2

Why was my Charlotte workers’ compensation claim denied?

Unfortunately, it’s not uncommon for an insurance company to deny an employee’s initial workers’ compensation claim. In fact, the most common reasons a claim is denied are that an employee incorrectly reported the claim or filed the claim too late.

Even if you file your claim properly, your employer may deny it anyway, blocking your access to the benefits you likely already need. In our experience, this is usually because an employer doesn’t want to pay for increased premiums. This is a good time to get an attorney on your side to begin building a solid case to secure benefits.

Your claim may have been denied for a variety of reasons:

  • Missed deadlines. Failure to report an injury can result in a denial of a claim. North Carolina law requires injured workers to fill out Form 18 and provide it to their employer as soon as possible or within 30 days. Submitting paperwork as soon as possible increases your chances for a successful claim – visit the North Carolina Industrial Commission (NCIC) to find out more.
  • Inadequate information. Another common reason for denial is missing information. This can be something as small as forgetting to fill out a few boxes, or failing to provide enough medical information to prove your injuries are severe enough to warrant benefits.
  • Injury outside scope of employment. If your employer finds your injury or accident did not occur on the job, they will also deny your claim. Workers’ compensation only covers injuries and conditions resulting from employment-related incidents.
  • Self-inflicted injuries. Workers’ compensation also bars collecting benefits when injuries result from intoxication or intentional misconduct.
  • No causation. If your employer cannot make a connection between the incident and your injuries, they will likely deny your claim. Our attorneys can work with your physicians as well as get second opinions to help show a clear connection.

However, a denial does not mean the end of the road, and you certainly do not have to give up.

What happens after my Charlotte workers’ compensation claim is denied?

When your workers’ compensation claim is denied, you’ll receive a letter in the mail explaining the reason for denial of benefits. This letter is just the starting point of the appeal process.

Our Charlotte attorneys can review the information and help you submit a Form 33 to the North Carolina Industrial Commission (NCIC), your employer, and the insurer. We can help ensure the form is filled out accurately and returned promptly. The NCIC then schedules a hearing, and a judge will review the circumstances of your case and any relevant medical evidence before making a final decision. Our attorneys will work with your doctors and other medical professionals to show the extent and effects of your injuries.

How does the workers’ compensation appeals process work?

After filing Form 33, the NCIC may contact you and your attorney and attempt to resolve the dispute without a hearing. However, if this proves unsuccessful, our Charlotte workers’ compensation attorneys can represent you at a formal hearing with an NCIC Deputy Commissioner, who acts as a judge. You are given the opportunity to provide sworn testimony regarding your accident and injuries, as well as present medical evidence.

The judge typically will not give an immediate decision, but rather will consider the evidence from both sides, as well as any written testimony from experts. Then you will receive a written opinion regarding whether you will receive your workers’ compensation benefits.

Both you and your employer have the right to appeal a decision with which they do not agree. Our attorneys are prepared to take your case to the North Carolina Court of Appeals or even the North Carolina Supreme Court, in the rare event it’s necessary.

Work Comp Appeals

How can I build a strong Charlotte workers’ compensation claim?

After an injury at work, you can build the strongest possible case from the start by taking the following steps:

  • Notify your employer of your injury and accident as soon as possible, even if you do not miss any work. Your injury may worsen over the next few days or weeks, and you will need a written record of the incident. If you are too injured to report your accident, a co-worker or family member can do so for you.
  • Get medical attention. If your employer requires you to see an approved medical provider, do so. You can also visit your own doctor afterward. Additionally, tell your physician your injuries occurred in a work-related accident and provide him or her with your employer’s name so your visit is designated correctly as a workers’ compensation incident.
  • Follow doctor’s orders – to the letter. Ensure you follow your physician’s treatment plan, including physical therapy, rest, and follow-up appointments.
  • File your claim in full and on time. Your claim must be filed with the NCIC as soon as possible, ensuring all information is correct. If the NCIC contacts you for further information, interviews, or documents, you are likely required to submit those as well. However, you also have the right to consult with your attorney first.
  • Make copies of everything. Make a copy of every form, every document, and every medical report you receive. This includes all expenses related to your injury. In the event of a denial, you will have all the evidence possible for an appeal or hearing.

Our Charlotte workers’ compensation attorneys can help you with all steps of this process, especially in cases of particularly severe injuries.

Is there a workers’ compensation attorney near me?

Yes. You can find Price, Petho & Associates at 1420 Elizabeth Ave in Charlotte. We also maintain offices in Rockingham and Rutherfordton. If you are unable to come to us, we can make arrangements to visit you at home or in the hospital for your convenience.

Our Charlotte workers’ compensation attorneys can help with the appeals process

Filing a workers’ compensation appeal can be stressful and complicated without effective legal representation. At Price, Petho & Associates, our Charlotte workers’ compensation attorneys can evaluate your case and guide you through the appeals process. We are paid on a contingency fee basis, so you can pursue benefits without worrying about your finances. To schedule a consultation, call 704-372-2160 or fill out our contact form today. We represent workers in Charlotte, Rockingham, Rutherfordton, North Carolina, and South Carolina.