A denial of workers’ compensation benefits can have profound financial implications.  If you are denied any benefits at all, you may not be able to pay your medical bills or receive disability income that you need when your injuries make it impossible for you to work. If you are denied coverage for medical treatment that you need, your care may suffer.

You do not have to accept a denial of workers’ compensation coverage. There are multiple stages of appeal to pursue. A Texas workers’ compensation lawyer at Abbott and Associates, L.L.C. can help you to understand the appeals process and will work with you to fight a denial of your claim. We will explain your options if you are not satisfied by a judge’s decision in a workers’ comp case and we will fight for you at every step of your claim to try to get you the benefits you deserve.  Call today to learn more.

What if You re Not Satisfied by a Judge’s Decision in a Workers’ Comp Case?

When your workers’ compensation benefits are denied, the initial appeals process is all handled internally by the Texas Workers’ Compensation Division. Your case does not actually get to a judge until you have gone through an entire administrative appeals process.

The first step after your benefits are improperly denied is to request a benefits review conference (BRC) to be held at a local office of the Department of Workers’ Compensation. You can attend this conference and should bring a legal advocate with you in many situations. A representative of the insurer will also attend the conference. The meeting is an informal one and the goal is to discuss the dispute over benefits and try to reach an agreement.

If you are unable to come to an agreement at the benefits review conference, there are two different options for the next stage of appeal: you can submit to binding arbitration or go to a contested case hearing (CCH). If you decide on binding arbitration, you should be aware that the decision of the arbitrator is final and you have no further ability to pursue an administrative appeal. Before deciding on arbitration, be sure to talk to a workers’ compensation lawyer about whether that is really the best option for you.

If you choose a contested case hearing, the CCH is going to be presided over by a hearing officer working for the Department of Workers’ Compensation.  The hearing officer will issue a written decision.   If you are not happy with the decision that was made, you can make a request to the internal appeals panel. This panel is still part of the Department of Workers’ Compensation.  The appeal involves a written statement explaining why you believe the hearing officer made the wrong decision.

If you are unhappy with the decision the appeals panel makes, only then do you appeal your case to a judge. The judge will determine whether appropriate prior actions were taken on your case and will issue a ruling.  This ruling is usually the last option you have to try to overturn prior decisions. While you can sometimes appeal the decision an appellate court judge makes to the Texas Supreme Court, these types of appeals are not commonly heard.

The Texas workers’ compensation lawyers at Abbott and Associates, L.L.C. can help you throughout the administrative and judicial appeals process. To learn more, contact us today.

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