What You Can Do When Your Claim is Denied

After the proper procedures have been followed by an injured worker, it may seem like a waiting game begins. The stress of recovering from your job accident or job injury can be exacerbated by worrying about whether you will receive enough benefits to cover your medical expenses and lost wages. After what can seem like an eternity of delay, an injured worker might receive a notice denying him benefits. This does not have to be a dead-end situation.

In these circumstances, an injured employee may benefit from hiring legal counsel. A workers' compensation attorney may file a motion to compel the workers' compensation insurance carrier to comply with the legal requirements of promptly admitting or denying the employee's claim to benefits. In North Carolina, an employee who submits a written notice of claim is entitled to a detailed statement from the employer or workers' compensation insurance carrier within 14 days of the defendants' position on acceptance or denial of the employee's claim. If your claim is denied, you may request a specific statement from the workers' compensation insurance carrier as to the reasons for the claim being denied.

Request for Hearing - What is a Form 33?

If your workers' compensation claim is denied, you have the right to request a hearing on the merits of your claim by filing a Form 33 "Request for Hearing" with the North Carolina Industrial Commission. Generally, the North Carolina Industrial Commission will order all cases in which a hearing is requested to host a mediated settlement conference before the hearing is conducted. If a mediated settlement conference cannot bring the parties in a workers' compensation case to terms, then a hearing will be held before the Industrial Commission, which may issue a ruling in your case.

What is a Mediation?

The North Carolina Industrial Commission requires that the disputing parties hold a mediated settlement conference in order to determine if a workers' compensation case or issue can be resolved by settlement on terms agreeable to both parties. This is commonly called a "mediation." Our workers' compensation team hosts mediations on behalf of our clients on a consistent basis, and has assisted hundreds of individuals with successful outcomes on their workers' compensation claims. If you have been injured on the job, call us now to see if our workers' compensation team can help you with your workers' compensation claim.