For more than 19,000 injured workers in Louisiana, workers’ compensation claims provide financial relief and medical support while they recover. Unfortunately, many of these claims are denied due to disputed injuries or insufficient documentation, leaving workers and their families facing financial hardship.
Act quickly by consulting a skilled Louisiana workers’ compensation lawyer after a workers’ compensation utilization review denial to challenge the decision and explore your legal options. With an attorney’s help, you can file an appeal and pursue the medical assistance you deserve.
Learn when to contact an attorney after a workers’ compensation denial and what they can do to help you receive your entitled benefits after a workplace injury.
Understanding the Louisiana Workers’ Compensation Appeals Process
Denials can occur for various reasons, including disputes over the injury’s severity, claims of pre-existing conditions, or missed filing deadlines. Receiving a denial doesn’t mean your case is over; it’s the starting point for the appeals process.
An overview of the appeals process in Louisiana:
Step | Description | Deadline |
Review the Denial | Examine the claim denial letter to understand the reasons, such as disputes over injury severity or missed deadlines. | Immediately after receiving the notice. |
Request Reconsideration | Contact your employer or insurance company to clarify errors or provide missing documentation for reconsideration. | No specific deadline; act promptly. |
File a Disputed Claim | Submit Form LWC-WC-1008 (Disputed Claim for Compensation) to formally dispute the denial. | Within 15 days of disputing a Medical Director’s decision or 1 year from the date of injury for indemnity benefits (3 years if medical benefits have been paid). |
Respond to Form LWC-WC 1002 | If you receive a Form LWC-WC 1002 disputing your benefits, you must provide written disagreement to the employer/payor.
Complete the Notice of Disagreement section on the form and return it with the original by mail or fax. | If the employer does not respond within 7 days, you can file or amend a Form LWC-WC-1008 to continue the dispute. |
Mediation | Attend a mandatory mediation session to resolve disputes about the denial without proceeding to a formal hearing. | Scheduled by the Office of Workers’ Compensation Administration (OWCA) District Office. |
Hearing | Present evidence and arguments before a workers’ compensation judge for formal litigation. | As scheduled by the court. |
Appeal to Higher Courts | If dissatisfied with the judge’s decision, file an appeal with the appropriate Circuit Court of Appeal. | Within 30 days if you want to pause enforcement of the decision while appealing; otherwise you have 60 days to file. |
Why Acting Quickly Is Crucial After a Denial
While some claims allow up to a year to file, disputes often require action within as little as 15 days, leaving little room for delay. Taking prompt action ensures you meet the necessary deadlines and helps strengthen your appeal.
Delays can make it harder to collect crucial evidence, like medical records and witness statements, which may no longer be available or accurate later. Waiting too long can also add financial stress, especially if you’re unable to work or manage expenses.
Starting the dispute process early with the help of a knowledgeable workers’ compensation attorney protects your right to appeal and increases your chances of receiving the benefits you’re owed.
How a Lawyer Can Help Your Workers’ Compensation Appeal
Managing the workers’ compensation appeal process can be overwhelming, especially if you’re already dealing with the physical and emotional toll of a workplace injury. Hiring a qualified workers’ compensation lawyer ensures your appeal is handled professionally and thoroughly. Here’s how the team at Dudley DeBosier can help:
Evaluate the Denial
Our attorneys will review your denial letter to identify why your claim was rejected and develop the best strategy for your appeal. This can include:
- Obtaining detailed medical records
- Correcting missed or incomplete paperwork
- Gathering expert testimony
- Challenging claims that your injury isn’t work-related
Gather Evidence
We will gather all the essential evidence to build a strong case, including medical records, employment documentation, and expert testimony. For example, we may obtain detailed statements from your physician to establish a clear connection between your injury and your job and payroll records to demonstrate lost wages.
Our team can also work with vocational specialists to validate the extent of your injuries and their impact on your ability to work.
Handle Deadlines and Paperwork
Your attorney will manage the strict deadlines and paperwork involved in the workers’ compensation process. They can ensure you submit all documents accurately and on time, reducing the risk of errors that could jeopardize your case.
Represent You in Mediation and Hearings
If your case advances to mediation or a hearing, our attorneys present your claim directly to the mediator or judge. We will address disputes and counter flawed arguments head-on, exposing inconsistencies in employer evidence and arguing against inaccurate claims to uphold your rights.
During mediation, we negotiate firmly to obtain a settlement that fully accounts for the impact of your injury and losses.
Protect You from Retaliation
In some cases, employers may retaliate against workers following a workers’ compensation dispute. If you face wrongful termination, demotion, or harassment after filing a claim, take action immediately.
Our attorneys can help you hold your employer accountable for retaliation by filing a complaint with the Louisiana Workforce Commission and pursuing legal action for damages.
Contact Dudley DeBosier Injury Lawyers for a Free Case Review
If your workers’ compensation claim has been denied, delaying action could limit your ability to appeal and recover the benefits you need to cover medical bills, lost wages, and other expenses.
At Dudley DeBosier Injury Lawyers, our Louisiana workers’ compensation attorneys understand the challenges injured workers face. We are committed to helping you fight for the benefits you need to support yourself and your family while you recover from your injuries.
Contact us today for a free consultation. We can discuss your case and advise you on the next legal steps for your appeal.
Disclaimer: This content has been reviewed by Scott Sonier, Workers Comp Attorney at our Baton Rouge office.