My Employer Denied My Workers’ Comp Claim
What can I do?
The Alabama legislature implemented the system of workers’ compensation to benefit both employers and employees. Employees who get injured receive compensation for lost wages and medical expenses without having to sue their employers and prove that the employer was negligent. This saves attorney fees, time and stress. It provides certainty to the employer and employee and allows the employer–employee relationship to continue amicably. Employers know that, except for highly unusual circumstances, they do not have to face a lawsuit with potentially astronomical damages from the employee since injured workers who accept workers’ comp generally waive their right to sue.
Things do not always go smoothly, however. At times, an employer or insurance company disputes the employee’s right to workers’ comp benefits, or the necessity or quality of medical care provided. In this case, what can an employee do?
In 1992, the State of Alabama created an ombudsman program for situations like these. An ombudsman is an independent third party who works for the state to help mediate disputes related to workers’ compensation. When an employer denies an employee’s claim, the employee can contact the Workers’ Compensation Division of the Alabama Department of Labor, and request mediation, called a benefit review conference.
If both the employer and employee agree to hold a benefit review conference, then the mediator meets with both parties, first together and then separately, to bring the sides to agreement. The mediation is confidential and cannot be used against the parties if they can’t agree and later find themselves in court. As in all matters when one’s legal rights are at stake, it is important, though not required, to have an experienced workers’ compensation attorney at the benefit review conference.
If the parties don’t come to an agreement, the employee may go to court to seek relief. If the parties come to an agreement, it is binding unless one of the sides appeals and the court overturns the agreement within 60 days of signing the agreement.
If your claim for workers’ compensation benefits has been denied or disputed, we can help represent you and fight for your benefits. Our attorneys have years of experience in workers’ compensation. Contact us for a free consultation.