Workers’ Compensation benefits are the right of every worker in Oklahoma – but they are not always guaranteed. The insurance company that provides your employer Workers’ Compensation coverage may deny your claim for any number of reasons. If your OK Workers’ Compensation claim was denied, you have options. An OK Workers’ Compensation Attorney can help you file an appeal to reverse the denial and get the benefits you deserve.
Reasons for an Oklahoma Workers’ Compensation Claim Denial
Workers’ Compensation claims are denied on a regular basis, mostly for small omissions or inadequate information. Common reasons that your Workers’ Compensation injury claim may be denied include:
- Failure to report the injury according to the established timeline
- Your injury was not work-related
- Your injury was caused by negligence or substance abuse
- You refused medical treatment for your injury
- Inadequate medical documentation of your injury
- Questionable injury at work claim
If your claim was denied, take the following initial actions:
- Examine the stated reason for your denial. This should be included in your official denial letter from the insurance company. Now you can begin correcting any mistakes that may have caused your denial.
- Review your claim paperwork. Any errors on the claim submission can result in a denial. Sometimes your doctor, a specialist, or your employer can make inadvertent mistakes that lead to a denial. Seek their assistance with making any necessary corrections.
- Partner with an experienced OK Workers’ Compensation Attorney. They can help review any claim documentation for common errors, resubmit your claim and defend your rights throughout the appeals process. Their assistance can often be the key to having your rejection reversed.
What Can I Expect from the Workers’ Compensation Appeal Process?
The Oklahoma Workers’ Compensation appeals process has changed since February 1, 2014. From this date, Oklahoma follows a new administrative process for handling appeals.
ALJ Hearing
Each case is assigned to an Administrative Law Judge (ALJ) who will preside over a hearing. This is an actual trial, and is an opportunity to submit evidence to support your claim for review, such as documents and witness testimony. After hearing your case and the insurer’s arguments for rejecting the claim, the ALJ will issue a decision.
Voluntary Mediation
Sometimes, the Administrative Law Judge may recommend (or in some cases order) a mediation process with an independent third-party mediator. This is an informal conference during which the mediator will attempt to formulate a workable solution for both parties. The mediator cannot force a decision on the dispute. If this process does not reach a solution, your case is referred back to the ALJ for a hearing.
Workers’ Compensation Commission
If your claim is denied again, and you disagree, you still have options. The next level of appeal is to the Workers’ Compensation Commission. You have ten days after the ALJ hearing to file an appeal. They will review your claim and evidence and render a judgement.
Oklahoma Supreme Court
If you’re not satisfied with the Commission’s decision, you may file an appeal with the Oklahoma Supreme Court within 20 days. The court may or may not decide to hear your appeal, or they may refer the case back to the Workers’ Compensation Commission.
Seasoned Help with OK Workers’ Compensation Claim Appeals
The Armstrong Law Firm PLC provides seasoned, knowledgeable, and compassionate counsel and legal representation for injured Oklahoma workers to help them get the benefits they deserve under the law. Let us provide valuable assistance when your Workers’ Compensation claim is denied in Oklahoma. Contact us today to schedule a free case review and get help to receive the benefits you deserve. We are ready to help!