Workers’ compensation payments are meant to give employees in Indiana some relief from the financial effects of a workplace injury or illness. Workers’ comp. is available to help pay for medical treatment and part of your wages that you might lose if you were unable to return to work immediately. For a variety of reasons, insurers may decide to deny the claim and then you must go through the complicated appeals process. With the help of a dedicated workers’ compensation attorney and good organization you can still win an appeal and obtain rightful compensation. Workers' Compensation Law in Indiana The Indiana Workers’ Compensation Board is responsible for overseeing workers’ compensation in Indiana. If you are injured or become sick at work you should inform your employer as soon as you are able to do so. There is a 30-day limit on providing this information. A claim should be filed with the insurer within 2 years of the accident or illness. Not every employer needs to take out workers’ comp. insurance. Some employers are exempted, such as independent contractors and railroad companies. Of course that means their employees are not covered in the event of an injury or illness. In Indiana, workers’ compensation payments pay for all medical costs as well as two thirds of average earnings for time that is spent away from the job because of the injury or illness. In Indiana, some mental illnesses that have been acquired at work are covered by workers’ comp. Why Your Claim Could Be Denied Workers’ compensation claims can be denied for a number of reasons by the employer’s insurer. Many of the insurer’s reasons for a denial can be rebutted but it takes time and energy to make an appeal. Some of the reasons for a denial are administrative errors. This can happen easily if you work for a large employer. The insurer is simply responding to incorrect information that you were not at work when you said that you were injured. Insurers may also claim that your injury or illness did not occur at work but may have been a pre-existing condition. There are other more serious reasons why you claim may have been denied. They may not be true, but insurers are never that happy about paying out for claims! The workers' comp insurance company may, for instance, claim that you: did not take any notice of safety measures at work leading to an injury; deliberately created the conditions that lead to an accident so you could claim compensation were intoxicated or had taken illegal drugs that caused your injuries; failed to inform your employer on time or failed to file a claim on time. The Indiana Workers' Comp Appeals Process If your claim has been denied, and you are convinced that the denial is unjustified, then you should file an appeal with the state’s Workers’ Compensation Board. There is a set procedure to follow if you decide to file an appeal. There are forms to fill in like the Application for Adjustment of Claim form. It is always advisable to file the appeal as soon as you can after being notified of a denial, although officially you have two years after the accident or illness to file the appeal. There may be a chance of mediation before a more formal appeal. If your payments have been stopped by the insurer, you may need to contact the Ombudsman rather than the Workers’ Compensation Board. The hearing is more or less like a trial, but less rigid. The judge will examine your evidence that you have available to support the claim as well as anything that the insurer has. It pays to be as well prepared for the hearing as you can be. There are higher levels of appeal available even if the hearing does not support your claim. Why a Workers' Comp Attorney May be of Help A workers’ compensation claim denial appeal can be stressful and is a complex and very formal process. You can rely on the fact that your employer’s insurer will be well represented legally. It doesn’t make much sense to try and go through the appeal process all by yourself. You are much more likely to obtain the compensation which is rightfully yours if you use an experienced workers’ comp. attorney to help you, and you likely won't need to pay up front for their services, as workers' comp lawyers work on contingency.
