Appealing a workers’ comp denial can be complicated and time-consuming. It often involves a medical exam and several legal proceedings.
Independent Medical Examination
If your employer's insurance company disagrees with a decision by your treating doctor about your medical treatment, the insurer usually has the right to demand that you be evaluated by a doctor of its choice at an Independent Medical Examination (IME). After the IME, the doctor will prepare a report, which you can dispute if it contains any factual inaccuracies.
Mediation or Settlement Conference
A workers' comp judge will often require you to participate in a settlement conference or mediation. At the mediation, a neutral third party will help you and the insurer attempt to resolve your claim informally.
Workers’ Comp Hearing
The workers' comp hearing is your opportunity to make your case to a judge if you are unable to settle your claim. The hearing usually involves arguments by the lawyers, testimony by witnesses (including your own testimony), and presentation of evidence such as medical records, documents showing lost wages, and doctors’ reports. The judge will then make a decision. You have the right to appeal the decision if the judge rules against you.