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Denver Workers’ Compensation Attorney Explains how To Appeal a Denied Claim

Mark A. Simon Dec. 13, 2017

Employees who are injured at work are typically entitled to workers’ compensation benefits. But according to Denver workers’ compensation attorney Mark A. Simon, being entitled to benefits does not mean you will automatically receive them after an injury. If your request for workers’ compensation is rejected, it’s important to appeal the decision. Here’s how:

Request A Settlement Conference

Most people attempt to settle their claims in a settlement conference before requesting a formal hearing. An administrative law judge (ALJ) presides over the settlement conference and helps both parties resolve issues in the case. The ALJ can also ask both parties to exchange information related to the case with each other, since sharing this information could lead to resolutions.

If the issue can be resolved in a settlement conference, there’s no need to move forward with the formal hearing. However, the hearing is still an option if you are unable to reach an agreement with the insurance company during the conference.

Request A Formal Hearing

To request a formal hearing, fill out the Application for Hearing paperwork and submit it to the Office of Administrative Courts. You will also need to send a copy of this paperwork to the insurance company that has denied your claim.

An ALJ also presides over this type of hearing, where both sides will be allowed to submit evidence supporting their case. After the judge hears both sides, the hearing will come to an end. The ALJ will then review the information that has been presented and release a written decision that outlines who the judge is siding with and why. This written decision will not be released on the day of the hearing, so you will have to wait to receive it in the mail to learn the outcome. See the Division of Workers’ Compensation employee’s guide for more information.

Next Steps

If you disagree with the judge’s ruling, you will need to file a Petition for Review within 20 days. Both parties will draft a brief that outlines why they agree or disagree with the judge’s decision. The ALJ that presided over the formal hearing will get a chance to review these briefs to determine if he would like to reverse his original ruling. If he does not wish to do so, the case will be sent to the Industrial Claim Appeals Panel, who will review the files and issue a decision within 60 days.

If you do not agree with the Panel’s decision, the next step in the process would be appealing to the Colorado Court of Appeals. Cases can also be appealed to the Colorado Supreme Court if the injured worker does not agree with the decision made in the Colorado Court of Appeals. However, workers’ compensation cases rarely make it this far through the appeals process since most can be resolved in the early stages.

If you are injured at work, don’t hesitate to seek legal representation from an experienced workers’ compensation attorney. Mark A. Simon will aggressively fight to ensure that you are awarded the compensation that you deserve for your injuries. Call us or contact Mark A. Simon to discuss your legal options during a free consultation.