Denied Workers Compensation Claim Attorney in Charlotte

Workers’ compensation insurance can help anyone who suffers an injury while working recover, but navigating the claim filing process can be challenging. Even if your case seems straightforward, you could be met with an unexpected denial that you do not know how to address on your own. A Charlotte denied workers’ compensation claim attorney can help you understand your options for resolving this situation and getting the benefits you deserve.

Experienced Legal Counsel for Denied Workers’ Compensation Claims in Charlotte, NC

The attorneys at Ayers, Whitlow & Dressler have extensive professional experience guiding our clients through the workers’ compensation claim filing process. In every case we accept, our goal is to help our client maximize their benefits in the shortest possible timeframe. While we are often able to streamline our clients’ cases significantly, some claims are unfairly and unexpectedly denied for many reasons.

When you have a denied workers’ compensation claim attorney in Charlotte, North Carolina handling your case, you can approach any such incident with confidence and peace of mind. Many workers’ compensation claims are denied on a technicality or due to clerical errors. However, it is also possible for a claim to be challenged on valid grounds or for complex discrepancies to arise in many ways.

Benefits of Hiring a Workers’ Compensation Attorney in North Carolina

The right attorney can help you make clearer sense of your situation and resolve any such issues with your claim more efficiently than you could manage on your own. Dealing with insurance companies can be challenging, but you also face the risk of receiving a claim denial due to your employer’s role in this claim-filing process. Ultimately, whatever your case entails, trust our firm to provide the guidance and support you need.

When you choose Ayers, Whitlow & Dressler to represent you, trust our team to compile a solid workers’ compensation claim that has minimal chance of being denied. However, if your claim is denied, you can count on us to respond swiftly and efficiently to resolve the matter as quickly as possible.

We have years of experience helping our clients navigate the workers’ compensation claim filing process and resolving denied claims. We know the tactics that insurance companies sometimes use to avoid liability for injured workers’ damages and how they sometimes attempt to take advantage of injured workers who may not fully understand the breadth of their rights.

With our assistance, you can approach your claim filing process with confidence and will be fully prepared to confront any unexpected challenges you might face with your claim. Additionally, you will not owe any upfront legal fees for our representation. We take all personal injury and workers’ compensation cases on a contingency fee basis, meaning you will only pay a fee if we win your case, and your fee will be a percentage of the case award you obtain.

The Standard Claim Filing Process for Workers’ Compensation Insurance in Charlotte

Almost every employer in North Carolina is legally required to have workers’ compensation insurance, and almost all workers are covered by this insurance. When a workplace injury occurs, the injured victim should report the incident to their employer immediately. Once the employer has been notified, they are required to create an incident report and provide the worker with the materials they will need to file their claim to the insurance carrier.

The purpose of workers’ compensation insurance is twofold. First, it provides limited immunity to liability for the workers’ damages to the employer. As long as they have appropriate coverage and facilitate legitimate claims as required by law, an employer should not face liability for an injured employee’s damages. There are, however, exceptions to this rule. Second, this insurance provides benefits to the injured worker to help them recover.

Once you have reported your injury to your employer, you will likely require a medical examination from a workers’ compensation doctor to file your injury claim for benefits. You can see any available doctor when you need treatment for an emergency, but you will likely need to visit a physician approved by your employer’s insurance carrier once you stabilize. Their job is to assess the severity of your condition and report their findings to the insurance carrier.

After completing these initial steps, you should be ready to submit your claim to the insurance carrier. Just like with any other insurance claim, the insurer will review the details of your claim. They may contact you and/or your employer for additional information, and then they will deliver their answer. They are required to respond to claims as expeditiously as possible, and a Charlotte personal injury attorney can help ensure your claim is processed in a timely manner.

Addressing Employer Retaliation and Interference

All employers that are legally required to have workers’ compensation insurance in North Carolina must handle employee claims in good faith. Unfortunately, not all employers uphold this responsibility. Some attempt to discourage injured workers from filing claims or even take retaliatory actions against them in response to their requests to file claims. This is usually due to worry that their insurance premiums will increase.

Your employer is legally required to provide you with the forms and other materials needed to file your claim. If they refuse, or if they interfere with your claim, it could form grounds for a separate legal claim against them. It’s a good idea to consult with experienced workers’ compensation attorneys as quickly as possible after your injury to ensure you are prepared to face any such resistance you encounter to your claim.

Benefits Available Through Workers’ Compensation Insurance in Charlotte

The purpose of workers’ compensation benefits in Charlotte is to ensure the injured worker can recover as much as possible by providing two forms of benefits: medical expense coverage and wage compensation. Medical expenses are straightforward; the injured worker can expect their employer’s insurance company to pay for all medical care related to their work injury. Wage compensation, however, is more variable.

It’s possible for an injured worker to receive partial disability benefits if they can still work at a limited capacity following their injury. These benefits are aimed at making up the difference in their earnings. The employee will need to report their weekly income to the insurer as well as all changes in their medical status, and these payments can continue until they are able to return to work at their previous earning capacity.

If an injured worker cannot work at all during recovery, they can receive total disability benefits paid each week for up to 500 weeks or until they recover enough to return to work. Each weekly payment will be about two-thirds of their average weekly pay during the year prior to their injury. The maximum weekly benefit amount changes each year, and your attorney can advise you as to how much you can reasonably expect.

Proving Eligibility for Workers’ Compensation Benefits in Charlotte

It is important for any injured worker to know how workers’ compensation claims are addressed in North Carolina and which injuries qualify for benefits. First and foremost, an injury must be work-related for it to qualify for workers’ compensation. This means the injury must have occurred directly from the victim performing their job duties and/or a specific incident that occurred while they were working.

It is important to remember that you cannot file a workers’ compensation claim for an injury that occurred while you were going to or coming home from work. Accidents that happen during your commute will not be covered by workers’ compensation. However, if you were injured in an accident that occurred while you were driving as part of your job duties, it would qualify for workers’ compensation.

Discrepancies may also arise when a preexisting injury is aggravated by an employee’s work duties. For example, if you have a preexisting condition that was made acutely worse by your job duties, it can still qualify for workers’ compensation benefits. However, there may be disputes concerning which medical treatments the insurance company is actually required to cover and which are not their responsibility.

Fault is also another issue that might arise in a workers’ compensation claim. Most claims are processed on a no-fault basis, meaning an injured worker does not need to prove fault for their injury in order for them to qualify to receive workers’ compensation benefits. However, if they caused their own injury because they engaged in horseplay at work, violated safety rules, or were working under the influence of drugs or alcohol, these would be grounds for denial.

Fault could also come into play if a specific party directly caused the injury or if the injury occurred because of any party’s intentional and illegal misconduct. In these cases, injured Charlotte workers may not only qualify for workers’ compensation benefits but also have grounds to seek additional compensation with third-party personal injury cases.

Why Are Workers’ Compensation Claims Denied in North Carolina?

Even if you complete all the filing steps correctly and believe that your injury should be covered by workers’ compensation insurance, it is possible for your claim to be denied for many reasons. Some of the most commonly cited reasons for workers’ compensation claim denials in Charlotte include:

• Employment status disputes. Some employees are not covered by workers’ compensation in North Carolina. While employers are required to categorize their workers accurately, some will intentionally misclassify employees as contractors or other exempt workers so they will not have to cover them with workers’ compensation insurance. If you believe this has occurred, consult your attorney as to how you can address this.
• Eligibility discrepancies. It is possible for your claim to be denied if the insurance company determines you are ineligible for benefits because of how the injury happened. While it’s possible to have caused your own injury and still qualify for benefits, it is only true if you caused the injury accidentally through a mistake made while working in good faith. The insurer may also claim your injury is not work-related.
• Clerical errors. Problems with your claim forms and other paperwork can sometimes result in denial, but your attorney can help you resolve any such issues efficiently and re-file your claim.
• Disputes regarding injury severity. An insurance company may claim that your injury did not result from work or that it is not severe enough to qualify for benefits. Your medical evaluation from a workers’ compensation doctor will be an essential step in the claim filing process, and if you encounter any problems with this, you will need an attorney’s help to ensure your injury gets the attention it deserves.
• Missed reporting and filing deadlines. If you do not file your workers’ compensation claim within the statute of limitations, or if you did not report your injury to your employer within the applicable time limit, missing any such deadlines could lead to a denial of your claim. This type of issue cannot be appealed, so it is important to meet all applicable deadlines with your workers’ compensation claim.
• Accusations of fraud. It is possible for an insurance company to claim that you have been fraudulent with your submissions or that you have attempted to unlawfully secure benefits to which you are not legally entitled. These are serious accusations, and workers’ compensation fraud can lead to severe criminal penalties. If you are accused of fraud, it is imperative to seek legal counsel immediately to help you clarify the situation.

Ultimately, it is possible for any injured worker to encounter unexpected challenges with their workers’ compensation claim, including a sudden denial. When this occurs, it is crucial to consult a denied workers’ compensation claim attorney in Charlotte to help you assess and resolve the situation as swiftly as possible.

Appealing a Denied Workers’ Compensation Claim in Charlotte

When your workers’ compensation claim has been denied, the insurance company will send an explanation for the denial. At this point, it is crucial to work with a trustworthy denied workers’ compensation claim attorney in Charlotte to help you resolve the situation. It’s possible to have your claim reconsidered and approved, but the appeals process can be complex, and you must be prepared to have the greatest chance of success with your appeal.

The North Carolina Industrial Commission (NCIC) is the state agency responsible for addressing denied workers’ compensation claims and fielding appeals of denied claims. First, you and your attorney should carefully review the denial letter from the insurance company. Your attorney can determine whether the denial has any fair reasoning behind it and whether you have grounds for an appeal. If so, they will help you write a formal request for a hearing with the NCIC.

Your denied workers’ compensation claim attorney in Charlotte will then assist you in compiling a strong case to present at your hearing. You may need to secure additional medical records, witness statements, and other evidence to prove the reality of the situation. The evidence you will need will vary based on the reason given for your denial.

At your hearing, you will have the opportunity to present your case to a deputy commissioner of the NCIC. At this point, they may either reverse the appeal and order the insurance company to issue a determination of benefits, or they may deny your appeal. In the latter case, your attorney can help you submit another appeal before the full NCIC.

If your claim is again denied by the full NCIC, you would then need to take the case to the North Carolina Court of Appeals. This will entail substantial litigation that can take a long time to resolve. You will have the greatest chance of success at all stages of your appeal process when you have the right attorney representing you.

Pursuing Additional Compensation for a Work-Related Injury

Workers’ compensation insurance protects covered employers from civil liability for their injured workers’ damages as long as they handle work injury claims in good faith. However, there are some situations in which an employer could face liability for an injured worker’s damages even if they have appropriate insurance coverage.

These situations typically involve employers who fail to address known safety hazards before they can cause harm to employees or if employers cause harm to employees through intentional actions. For example, if your employer coerced you to perform a task outside of your usual job duties that had virtual certainty to result in an injury, they would likely face liability for the resulting damages.

In any such situation, the injured victim may have grounds to pursue a separate civil suit against their employer in addition to their workers’ compensation claim. It’s also possible for the injured worker to have grounds for a civil suit against a third party if anyone outside of their work caused their injury. For example, if you were hurt in a vehicle accident while driving for work, you could file a claim for workers’ compensation benefits and sue the at-fault driver.

Success with any alternative legal recourse could result in securing compensation for the damages that workers’ compensation insurance typically won’t cover. For example, the wage replacement benefits you receive may only amount to a portion of your total lost income from the accident, and you could claim the remainder through your civil suit. You could also seek compensation for your pain and suffering, which workers’ compensation insurance doesn’t cover.

What to Expect From Your Workers’ Compensation Attorney in Charlotte

One of the optimal ways of handling a denied workers’ compensation claim in Charlotte is to take steps to ensure you have the greatest chance of success with your initial filing. While it is possible for you to file your workers’ compensation claim on your own, hiring an attorney to help you will make the claim-filing process much easier, and your attorney can build a strong case that has a greater chance of success than a claim you would file on your own.

Your workers’ compensation attorney in Charlotte can ensure that your employer meets their legal requirements pertaining to your claim as well. If any issues arise, your attorney can help you resolve them efficiently and determine whether you have any grounds for legal recourse against an employer who has acted against you in bad faith. When it comes to dealing with an insurance company, your attorney can also ensure they handle your claim appropriately.

Success with a workers’ compensation claim in North Carolina requires clear proof that your injury occurred through the course of performing your job duties. While it is possible to have caused your own injury and still qualify for benefits, there are exceptions to this rule. Your attorney can help you determine whether any fault you may bear for your accident could influence the final outcome of your case.

When it comes to resolving an appeal, it is important to work with an experienced denied workers’ compensation claim attorney in Charlotte who has proven success in confronting insurance companies and the NCIC on behalf of their clients. Ayers, Whitlow & Dressler has successfully helped many past clients not only file their workers’ compensation claims but also resolve appeals when their claims have been unfairly denied.

Find Trustworthy Legal Counsel in Charlotte

When you are beginning the workers’ compensation claim filing process, or if you have already filed your claim and it has been denied, it is imperative to seek out an attorney who has proven experience handling cases like yours. The right attorney can have a tremendous positive impact on your workers’ compensation case, helping you to secure the benefits you legally deserve as quickly as possible.

Ayers, Whitlow & Dressler provides comprehensive legal counsel for all work injury cases in Charlotte. We can not only help you file your workers’ compensation claim and explore alternative avenues of legal recourse that may be available to you but also assist you with resolving unexpected claim denials and other issues you may not be able to address successfully on your own.

You have a limited time in which to appeal a denied claim, so it is vital to consult a denied workers’ compensation claim attorney in Charlotte as quickly as possible if you are faced with this issue. Contact Ayers, Whitlow & Dressler today to schedule a free consultation with our team and learn more about the legal services we provide that may assist with your recovery efforts.