Appealing a denied workers’ compensation claim

After an on-the-job injury in Texas, our team at The Law Offices of Miller & Bicklein, P.C., understands the strain that dealing with the workers’ compensation system may cause for someone who is hurting. Your situation may become even more difficult if your employer or its WC insurance company denies your claim. You do have options for appealing that decision, though.

The Texas Department of Insurance, Division of Workers’ Compensation explains that first, you need to speak to the insurance claims adjustor for your case. It may be that you can resolve the dispute with one phone call. However, you do not have to stop there if you are denied again. The TDI-DWC provides you with a further chance to resolve the issue at its local office through a benefit review conference. An attorney may be present at any and all parts of the dispute resolution process.

A dispute that still has not been resolved can either go to arbitration or a contested case hearing. If you choose arbitration, the decision reached by the independent arbitrator cannot be appealed again. On the other hand, if you opt for a formal hearing instead, a judge reviews the dispute and issues a decision. You can appeal that decision, but so can anyone else who is involved. An appeals panel reviews written statements from you and the other parties and provides a decision in writing.

You may be able to take your case to court if there is still a dispute. More information about workers’ compensation claim disputes is available on our webpage.