In the workers’ compensation context, winning does not always have the same meaning as it would in another type of case. For example, the biggest win that you could have is getting the benefits you need after you apply for them. This means that the insurance company has granted your claim and is paying you the medical benefits and wages to which you are entitled. In this sense, the best way to win your case is to put together a well-documented file that fulfills all the requirements. A Myrtle Beach workers’ compensation lawyer will be able to assist you with this.
What to Do When Your Claim Is Denied
Winning may take on a different form if the insurance company denies your claim. Then, you would need to file an appeal to get your benefits. Your case would have an administrative hearing where you could be granted benefits. You could take your case to court after that if you are unsuccessful. To win an appeal of a workers’ compensation denial, you should have the documentation necessary to show that the insurance company made the wrong decision. Here is what you must do to win your appeal:
- Hire an attorney as soon as you receive a denial (or before you even apply for benefits)
- Review why your claim was denied by the insurance company in the first place
- Strengthen the documentation of your claim, especially handling the area where the insurance company had questions
- Continue to negotiate with the insurance company
- Keep fighting for your rights unless you run out of appeals
It all begins with having a lawyer who is not afraid to take your case all the way to a hearing if necessary. This could put pressure on the insurance company to grant benefits. Showing them that you will fight may force them to talk. It is easier for them to deny benefits when they know that you will just take it and not fight back.
You Can Settle Your Claim with the Administrator
While you always have the right to file an appeal, you can settle your case with the claims administrator in the meantime. This would reduce your legal risk of an appeal and possible lawsuit. However, you need an aggressive lawyer who the claims administrator knows to take seriously. There are some cases where a compromise can still be a win.
In the end, the odds are in your favor for a workers’ compensation claim. Even the small proportion of cases that are denied may result in an eventual settlement. Very few workers’ compensation claims result in a trial. However, before you get to that point, you need an attorney to speak on your behalf. Oftentimes, the denial of the claim begins a process that leads to benefits, but you must still be prepared for a hearing.
Myrtle Beach Workers Compensation Lawyers
The attorneys at The Maguire Firm are tenacious advocates who take fighting for your legal rights seriously. We stand up to insurance companies in workers’ compensation cases. Call us today at (843) 438-5561 or contact us online to get started with your case.