November 11, 2011

How to Appeal a Workers' Compensation Denial

So, you were injured at work and you have now received a denial in the mail and are wondering what to do.  The denial will be in the form of a letter and will look something like this:

Dear Ms. Smith, 
After investigating your claim for an injury to your low back occurring on January 1, 2011, we are denying your claim for workers' compensation benefits....

Below this will be language in bold caps explaining how to appeal the denial.  However, that language can be a little confusing.  The most important thing to remember is that you have 60 days from the mailing date of the denial to appeal.  You can technically appeal it on your own, but it is much smarter to retain a workers' compensation attorney.  Oregon law requires that workers' comp attorneys work on contingency, which means they are not paid unless they obtain additional workers' compensation benefits for you.  The attorney fee will not come out of your benefits when the attorney helps you overturn a denial.  Because it will cost you nothing to have an attorney help you with your workers' compensation denial, it is very likely worth it to retain one.

If you would like to talk to an attorney, or have any questions about appealing your workers' compensation claim denial call the Alana C. DiCicco law firm at 503-975-5535 or post a response to this blog.  All consultations with workers' comp attorneys are free.  More information can also be found at

Why Was My Workers' Comp Claim Denied?

There are lots of reasons that insurance companies deny workers' compensation claims, but usually it is about money.  For example, most stress claims are denied as a matter of course.  They are difficult claims for the worker to prove and insurance companies save money by denying most stress claims.  The idea is that only a certain number of the claim denials will be appealed and only a certain number of the appealed denials will be overturned by the Workers' Compensation Board.

However, sometimes claims are denied for other reasons.  Maybe there were no witnesses to the injury, or the employer has some reason to believe the injury occurred outside of work.  Often, a workers' compensation claim will be denied if the insurance company suspects you have a preexisting condition that is the major cause of your new injury or occupational disease.

The most important thing to remember is that it is always worth it to retain a workers' compensation attorney and appeal your denial.  This is true even if you are not sure about your chances of having the workers' compensation claim denial overturned.  A workers' compensation attorney can help you gather evidence to support your case or negotiate a financial settlement if you do not want to have a hearing before the Workers' Compensation Board.

If you have a denied workers' compensation claim and have questions, or want to appeal it, you can post a question to this blog or call my law firm at 503-975-5535.  Consultations by phone or in the office are always free.

Additional information about denied workers' compensation claims can be found at