How Do I Appeal a Workers’ Compensation Claim Decision?

June 26, 2017

If your workers’ compensation claim was denied, you must appeal the decision to receive the benefits you need.

Unfortunately, the appeals process can be complicated and difficult to navigate on your own. Having an experienced Phoenix workers’ compensation attorney by your side can help ease the burden on your shoulders.

Contact our team today to learn more about how we can help you. We can further explain the steps in the appeal process detailed below.

Request a Hearing

If you are unsatisfied with the result of your workers’ compensation claim, you have 90 days to file a Request for a Hearing with the Industrial Commission of Arizona’ (ICA) Claims Division.

After you have filed a request for a hearing, the ICA will send you a notice informing you of the date and time of your hearing.

If you need to change the date of your hearing, you must mail or fax a request that explains why you are changing the date and provide documentation that supports your reason. You will need to send this information to the administrative law judge (ALJ) assigned to your case and your employer’s attorney.

Prehearing Conference

The ALJ assigned to your case may require you to participate in a prehearing conference before your in-person hearing begins.

The prehearing conference will be conducted over the phone, and the ALJ will discuss the details surrounding your workers’ compensation claim and the reason it was denied.

The ALJ will also ask if you intend to use any witnesses to the accident to support your case.

You must participate in a prehearing conference if your the ALJ chooses to hold one or your request for hearing may be denied.

Discovery Process

Before your case is heard, both sides of the dispute will engage in the discovery process by exchanging evidence related to the claim.

Arizona’s workplace injury report law requires you to participate in the discovery process and medical releases to allow your employer’s insurer and its attorneys to obtain medical records, tests and information from any medical professional who has treated you in connection with your workplace injury.

You may also be required to participate in a deposition if you receive a Notice of Deposition. This is an oral question-and-answer session conducted either in-person or by telephone.

If you oppose a discovery request, you can file a motion for protective order with the ALJ requesting an excusal. However, if your request is not granted by the ALJ, you must comply with the discovery process or your case will be dismissed.

Hearing

Your hearing will be held within 90 days after your case is referred to an ALJ. You will need to be present at the hearing, along with your attorney, your employer’s insurer and its attorney, the ALJ and a court reporter.

The hearing will begin with the ALJ introducing your case and reviewing the dispute. Since you have the burden of proof, you will be the first to testify.

The ALJ will likely ask you some initial questions and you may be cross-examined by the insurer’s attorney. In turn, you will also have the opportunity to cross-examine the defense’s witnesses.

The hearing is your only opportunity to present evidence that supports your claim. Our attorneys will help you organize any notes, records and physical evidence to effectively present your case.

We will also help you find witnesses who were present during your workplace accident and use their testimonies to support your claim. Likewise, we can prepare you to be cross-examined by the defense, as well as create your own list of questions to ask during the hearing.

Once the hearing is complete, the ALJ will make his or her decision within 30 to 60 days. A copy of the decision will be mailed to your last known address.

Further Appeals

If you are unsatisfied with your hearing’s decision, you may file a Request to Review within 30 days of the ALJ’s decision. You must make this request in writing and mail a copy to your employer’s insurer.

Once your request to review is received, the ALJ will reexamine the evidence in your case and issue a Decision Upon Review either confirming or changing the initial decision.

If you disagree with the ALJ’s reconsideration, you must take your case to the Arizona Court of Appeals within 30 days.

Contact Our Phoenix Workers’ Compensation Attorneys

It is important that you have strong and experienced legal representation on your side during a workers’ compensation claim dispute.

At Phillips Law Group, our workers’ compensation attorneys will help you appeal a denied workers’ compensation claim to receive the benefits you deserve.

We will review your claim through a free, no obligation consultation to determine if your claim was unjustly denied.

We work only on a contingency fee basis, which means the only time we charge for our services is after we successfully recover the benefits you deserve.

Call 1-800-706-3000 if your workers’ compensation claim was denied.