Appealing a Workers’ Compensation Decision in Montgomery County

Sometimes the initial decision in a workers’ compensation case does not go your way. That does not mean your options are exhausted. If your compensation claim was denied, you have the right to appeal the decision.

Appeals are common, and they could result in a reversal of the denial of your benefits. In some cases, these claims are denied over minor technicalities or missing documentation. A seasoned workers’ comp attorney could help you with appealing a workers’ compensation decision in Montgomery County.

Common Grounds for Denied Compensation Claims in Montgomery County

There are many reasons why the Workers’ Compensation Commission (WCC) might deny a claim. Many of these are based on technical deficiencies. For example, a claim could be denied if it is filed after the deadline expires. Some other common grounds for a denied claim include:

  • Failure to notify the employer
  • Use of drugs or alcohol
  • Failure to comply with doctor’s orders
  • The injury did not occur within the scope of employment

The Commission also frequently denies claims that lack the necessary documentation attached, including medical reports of the injuries which clearly state that the injury was caused by the job. Without appropriate evidence, a successful claim is unlikely. The good news is that a denial based on any of these reasons could be ripe for an appeal.

The Process of Appealing a Denial

Typically, a worker will receive a Notice of Issues Filed informing them that their claim was denied by the WC insurance company. If the worker believes the denial was wrongful or the benefits being paid award are incorrect, the claimant must file Issues to request a hearing before the WCC.

To request a hearing, an injured worker must submit a document known as the Issues Form to the Workers’ Compensation Commission. This form will identify the grounds for the appeal. In addition to providing the Commission with a copy of this form, an appealing worker must also supply a copy to their employer.

At the hearing, both sides will have the right to be heard. A Commissioner will oversee the hearing, essentially serving as a judge. The injured worker has the right to an attorney throughout the course of the hearing. At the end, the Commissioner will either uphold the denial or alter the award for benefits.

Further Appeals

Within 15 days of the decision by the Commissioner, a worker has the right to request a rehearing. The original Commissioner has the right to grant a rehearing, although it is uncommon. A rehearing is intended for situations where the Commissioner made a legal error during the initial hearing or there was newly discovered evidence.

The hearing or rehearing is not the end of the process. An injured worker has the right to appeal again, this time to the Circuit Court. The final step in the process could be an appeal to the Maryland Court of Special Appeals. A committed local lawyer could stand by a claimant’s side through every step of the workers’ comp appeals process.

An Attorney Could Help Appeal a Montgomery County Workers’ Comp Decision

If you receive an unfavorable decision during the workers’ compensation process, you still have options to pursue your claim. While the appeals process can be long and complex, a successful appeal could make the difference in whether you obtain the benefits you need. An experienced Montgomery County attorney could assist you with your workers’ compensation appeal from beginning to end. Call today to discuss the details of your case.