Workers’ Compensation Appeals

If your claim has been denied, your first step may be to request a reconsideration from the insurance company. In many cases, claims are denied because of incomplete medical records or miscommunications between the insurer and the worker. Before moving to a formal appeal, you can contact the insurance carrier, provide additional documentation, and ask for reconsideration.

When requesting reconsideration, it’s essential to:

• Provide all relevant medical records that demonstrate the extent of your injury.
• Include statements from your physician confirming the work-related nature of your injury.
• Ensure all paperwork is accurately completed, as minor errors can result in claim denial.

If your reconsideration is unsuccessful, the next step is to file a formal appeal with the Department of Labor. A skilled attorney can guide you through the process, ensuring all procedural requirements are met and providing a strong argument for your reconsideration.

In New Hampshire, workers’ compensation appeals are handled through a hearing process. The appeals process includes several steps:

Step 1: Filing the Appeal

After a denial, you can file an appeal with the New Hampshire Department of Labor. You’ll be required to submit a formal petition for a hearing within 18 months of your denial notice. This hearing will provide you the opportunity to present your case before an administrative officer.

Step 2: Mediation

In some cases, a mediation session is scheduled before the formal hearing. Mediation gives both parties an opportunity to resolve the dispute without going to a hearing. A neutral mediator helps facilitate discussion and negotiate a settlement. While not mandatory, mediation can sometimes lead to a quicker resolution.

Step 3: Formal Hearing

If mediation does not result in an agreement, the case proceeds to a formal hearing. During the hearing, both you and the insurance company will present evidence, including medical records, testimony from doctors, and witness statements. The hearing officer will review all the evidence and issue a decision regarding your benefits.

Step 4: Appeal to the Compensation Appeals Board

If you disagree with the outcome of the hearing, you can appeal the decision to the New Hampshire Compensation Appeals Board. This is a more formal process where a panel of judges will review your case and make a final determination. If necessary, further appeals can be made to the New Hampshire Supreme Court, though such cases are rare.

Timing is crucial, as any delays can affect the outcome of your case. Consult with a workers’ compensation appeals attorney to ensure your appeal is handled promptly and effectively.

While workers’ compensation is designed to support injured workers, obtaining benefits can be challenging for several reasons. 

Some of the common reasons for the denial of your worker’s compensation claim are:

• Lack of Medical Evidence: One of the most common reasons claims are denied is insufficient medical evidence. Workers must demonstrate that their injury is directly related to their job. If the injury is not well-documented or if the insurance company disputes the severity, benefits may be denied.
• Pre-Existing Conditions: If you have a pre-existing condition that may have contributed to your injury, the insurance company may argue that your condition is not work-related. Proving that your injury was caused or aggravated by your job is essential.
• Missed Deadlines: New Hampshire law requires injured workers to notify their employer of an injury within two years and file a claim for benefits within three years. Missing these deadlines can result in automatic denial of benefits, even if your injury is legitimate.
• Insurance Company Tactics: Insurance companies often seek to minimize payouts. They may claim that your injury is not as severe as reported or argue that you can return to work earlier than recommended by your doctor.

Our Approach

• Thorough Case Evaluation: We conduct a detailed analysis of your case to identify strengths and weaknesses, ensuring a solid foundation for your appeal.
• Expert Negotiation: Our attorneys are skilled negotiators, working tirelessly to achieve the best possible outcome during mediation.
• Comprehensive Representation: From filing paperwork to representing you at hearings, we handle every aspect of your appeal with dedication and precision.

A denied workers’ compensation claim doesn’t mean the end of the road. With the right attorney on your side, you can fight for the benefits you deserve. At Wyskiel, Boc, Tillinghast & Bolduc, P.A., we are dedicated to making this challenging process as seamless and stress-free as possible.

Don’t wait to take the next step in securing the compensation you need. Contact Wyskiel, Boc, Tillinghast & Bolduc, P.A. today for a consultation with a skilled workers’ compensation appeals attorney.

Understanding the legal timeframes for filing claims and appeals is essential for protecting your rights. Workers in New Hampshire have two years to report workplace injuries and three years to file a claim for benefits. If your claim is denied, you have 18 months to request a hearing.

Reporting Injuries and Choosing a Doctor

After a workplace injury, it’s critical to report it to your employer immediately and fill out an accident report. You have the right to choose your own doctor, and it’s important to inform them of the work-related nature of your injury. Proper documentation from your healthcare provider can be pivotal in supporting your claim or appeal.

First, don’t panic. Carefully review the denial letter and consult an attorney immediately. At Wyskiel, Boc, Tillinghast & Bolduc, P.A., we can guide you through the appeal process to give your case the best chance of success.

In some cases, exceptions may apply for missing the deadline, such as if you were misinformed about your rights. A NH workers’ comp appeal attorney can help determine if you still have options.

Workers’ compensation may cover medical expenses, a portion of lost wages, vocational rehabilitation, and disability benefits. Our workers’ compensation lawyers in NH can help ensure you receive the maximum benefits available.

The success of an appeal depends on the strength of your evidence and legal arguments. Hiring our experienced workers’ compensation attorney significantly improves your chances of success.

While it’s not mandatory, having an attorney greatly enhances your chances of success. Workers’ compensation laws are complex, and legal representation ensures your case is presented effectively.