Denied Workers’ Compensation Claim – What are My Next Steps?

In Wisconsin, most employees are covered by workers’ compensation insurance. If you were hurt on the job, workers’ compensation provides much needed medical benefits and wage loss benefits. Unfortunately, some injured workers struggle to get the full workers’ compensation they rightfully deserve. If your claim was rejected, you need to take immediate action to protect your rights. Here, our Milwaukee workers’ compensation attorneys highlight four important steps you should take if your workers’ compensation claim was denied in Wisconsin.

Step 1: Determine Why Your Claim Was Denied

As a starting point, you need to know exactly why your workers’ compensation claim was denied. You should have received a written denial letter, which provides a basic explanation. However, as these denial letters tend to be vague and filled with complicated, industry-specific language, you might still be confused. A Milwaukee workers’ compensation lawyer can help you understand precisely why your claim was turned down. Some of the most common reasons include:

• A mistake on the initial workers’ compensation application;
• Lack of sufficient medical documentation or vocational evidence;
• Disputes over whether the employee was truly “at work” when the accident occurred;
• Disagreement regarding the severity of the injuries;
• A claim the injury was actually a pre-existing condition; or
• Errors or bad faith by the insurer.

Step 2: Speak to a Milwaukee Workers’ Compensation Lawyer

After receiving a denial letter, you should consult with an experienced Milwaukee work injury lawyer right away. Your lawyer will be able to conduct a comprehensive review of your case to determine what action should be taken to protect your rights and interests. The appeals process is complicated — and much more so if you do not work with a qualified attorney by your side.

Step 3: File an Appeal — Request a Hearing

Your initial appeal must be filed directly with the Wisconsin Department of Workforce Development. To request a hearing, you should complete and submit Form WKC-7. Once you file this form, your case will be assigned to an administrative law judge. It is highly recommended you consult with a lawyer before your hearing actually occurs. To win an appeal, you must present a compelling claim, which is backed by strong supporting evidence.

Step 4: Escalate the Claim to the Labor and Industry Review Commission (LIRC)

If an administrative law judge declines to grant you the workers’ compensation benefits you deserve, you can escalate your workers’ compensation appeal to the next level. Please note: You only have 21 days after receiving a denial from an administrative law judge to file an appeal. This appeal will be handled by the Wisconsin Labor & Industry Review Commission (LIRC).

Get Help From Our Milwaukee Workers’ Compensation Lawyers Today

At Gillick, Wicht, Gillick & Graf, our Wisconsin workers’ compensation lawyers are dedicated advocates for injured workers. If your claim was denied, we are here to help. There is no fee for our services until you get paid. For a free, no obligation consultation, please contact our law firm today. With an office in Milwaukee, we serve communities throughout the region.