If your employer has opted into the Texas workers’ compensation system, this affects your rights after a work accident. Texas workers’ compensation is an exclusive remedy system. This means if you are eligible for workers’ comp benefits, you must make a claim though workers’ compensation instead of suing your employer if you get hurt on-the-job. Workers’ comp benefits will pay medical bills and can also provide ongoing income if your work-related illness or injury prevents you from working or limits your abilities.

Since workers’ compensation is an exclusive remedy system when your employer has opted in, the stakes are very high when it comes to making a workers’ comp claim. If your claim is denied, you could end up with nothing.  You need to protect yourself from financial loss, which means you should think about calling an attorney as soon as possible if a workers’ comp claim is denied.

You have options if you are not satisfied with the workers’ compensation board’s decision and an experienced Texas workers’ compensation lawyer at Abbott and Associates, L.L.C. can provide you with help fighting your benefits denial.

What Can I Do if I Disagree With the Workers’ Compensation Carrier’s Decision?

There are multiple different stages in the appeals process if your workers’ comp claim is denied by your employer’s insurer.  The first step is going to be requesting a benefits review conference (BRC). This will be held at a local Department of Workers’ Compensation Office and you will have the opportunity to discuss the disputed issues in an informal meeting.

If no agreement is reached, you can either opt for arbitration to resolve the dispute or you can go to a contested case hearing (CCH).  The CCH will be presided over by a Department of Workers’ Compensation Hearing officer. You’ll get a written decision after your hearing that will address your eligibility for benefits.

If you are not happy with the outcome of arbitration, there is nothing you can do- the arbitrator’s decision is final and not appealable. However, the decision of the contested case hearing office can be appealed.  You can submit a request and the Appeals Panel will review the decisions that were made before.

No hearing occurs at this stage. Instead, you will have the opportunity to submit a statement describing your position. You should have a Texas workers’ compensation lawyer prepare this statement on your behalf because you are counting on it to convince the Appeals Panel to agree with your position and not the decisions that have come before.  The workers’  compensation insurer that is trying to deny your claim can also submit a statement to the appeals panel.

The appeal’s panel is the last phase of appeals presided over by the Department of Workers’ Compensation. If you are still not satisfied with the workers’ compensation board’s decision, you will need to petition for judicial review.  Let Abbott and Associates, L.L.C. help you throughout this entire appeals process.  Call today to learn more.

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