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3 things to expect from a workers’ compensation claim appeal

On Behalf of | May 3, 2024 | Workers' Compensation

If you face a denied workers’ compensation claim, you may feel frustrated and uncertain about your next steps. Filing an appeal can seem complex, but understanding what to expect can help you navigate the system.

There are three key things to expect during your workers’ comp appeal.

1. A formal hearing

When you file an appeal, your case typically gets scheduled for a formal hearing before an administrative law judge. During this hearing, both you and your employer’s insurance company will have the opportunity to present evidence and arguments supporting your respective positions. Expect to testify about your injury, medical treatment and how the injury impacts your ability to work.

2. Additional medical evaluations

The judge may order an independent medical evaluation to assess your condition and determine the extent of your injury. A neutral medical professional who has not previously treated you conducts this evaluation. The IME report can influence the outcome of your appeal, so it is important to attend the evaluation and provide honest, detailed information about your injury and symptoms.

3. A potential settlement

During the appeal process, you may have opportunities to negotiate a settlement with your employer’s insurance company. A settlement can provide a lump sum payment or structured payments to compensate you for your medical expenses, lost wages and other related costs. Evaluate any settlement offer to ensure that the terms are fair and adequate. Consider the severity of your injury and its impact on your life and work.

The average workers’ comp settlement is approximately $20,000, though workers experiencing severe injuries could receive several times that amount. Understanding the appeals process will help you prepare to advocate for your rights and get the compensation you deserve after your injury.