If your workers’ compensation claim in Maryland gets denied, it can feel frustrating and discouraging. However, you have options to challenge the denial and potentially secure the benefits you deserve.
Reasons for a denied claim
Several reasons can lead to the denial of a workers’ compensation claim in Maryland. Common reasons include:
- Lack of evidence: If you cannot prove that your injury happened at work or during work-related duties, the insurer may deny the claim.
- Late reporting: Failing to report your injury promptly (within 10 days) may result in denial.
- Pre-existing conditions: If your injury stems from a pre-existing condition and you cannot show it worsened due to work, the claim may be denied.
- Failure to see an approved doctor: In Maryland, workers’ comp claims require you to see a doctor approved by your employer or the insurance company.
A disputed cause of injury could also be a reason for denial. If the insurance company believes your injury was not work-related, they may deny the claim.
Appeal the denial
If your claim is denied, you can file an appeal with the Maryland Workers’ Compensation Commission (WCC). You typically have 30 days from the denial date to file your appeal. The WCC will review your case and may hold a hearing to decide whether you’re entitled to benefits.
Request a hearing
If the WCC denies your claim, you can request a hearing. During the hearing, you can present evidence, witness testimony, and any other information that supports your case. It’s important to be prepared with medical records, accident reports, and any other relevant documentation.
Mediation
In some cases, the WCC may offer mediation to help settle the dispute without going to court. Mediation involves a neutral third party helping you and your employer’s insurance company reach a resolution. If you cannot reach an agreement during mediation, the WCC will move forward with a hearing.
Review by a judge
If mediation does not resolve the issue, a judge from the WCC will review your case. Both you and the insurance company will have the chance to present evidence. After reviewing all the information, the judge will make a decision. If the judge rules in your favor, your benefits will be granted.
If your workers’ comp claim gets denied, you have the right to appeal. Understanding the process and your rights ensures you can fight for the compensation you deserve.