Denied Workers Compensation Appeal

Summary

If your workers compensation claim is denied, you can appeal the decision with the Texas Department of Insurance, Division of Workers Compensation. File a written request for a contested case hearing within 15 days of the decision. You can also request a Benefit Review Conference (BRC) by submitting DWC Form-045. Gather evidence like medical reports and witness statements to support your claim. Consider consulting a workers compensation attorney for guidance.

Full Conversation

I got hurt at work and my workman's compensation Case by the adjuster was denied what can I do next and my employer lied about me getting hurt at work
Hey ****! I'm sorry to hear about your situation. You have a few options:
- You can file an appeal with the Texas Department of Insurance, Division of Workers' Compensation (DWC).
- Consider seeking the help of a workers' compensation attorney who can guide you through the appeal process and help gather evidence.

Would you like to be connected with a local lawyer who can assist you?
No
Hey ****! To get a better understanding of your situation, have you already gathered any evidence (like medical reports, witness statements) to support your claim?
Yes but they made a DEC ision without getting all the information by the adjuster of the insurance company by the employer
Case Rating: *
Hey ****! You can file an appeal if you believe the decision was made without all the necessary information. You can also request a benefit review conference (BRC) with the DWC to discuss your case further. Would you like more information on how to initiate an appeal or BRC?
Yes
Case Rating: *
To initiate an appeal or request a Benefit Review Conference (BRC) with the Texas Department of Insurance, Division of Workers' Compensation (DWC):
- Appeal: You can submit a written request for a contested case hearing to appeal the insurance company's decision. This must be done within 15 days of receiving the decision.
- BRC: You can request a BRC to discuss the issues with your claim. Submit DWC Form-* (Request to Schedule, Reschedule, or Cancel a Benefit Review Conference) to the DWC.
Would you like more detailed guidance on filing these documents?
Yes
Case Rating: *
To appeal or request a Benefit Review Conference (BRC) with the Texas Department of Insurance, Division of Workers' Compensation (DWC):
- Appeal: Submit a written request for a contested case hearing within 15 days of receiving the decision.
- BRC: Submit DWC Form-* to the DWC.
Would you like more detailed guidance on filling out these documents?
Yes
Case Rating: *
Hey ****! Here are the steps for filing the documents:
- Appeal: Write a request for a contested case hearing. Include your case details and reasons for the appeal. Ensure it’s submitted within 15 days of the decision.
- BRC: Fill out DWC Form-* with your case information and reasons for requesting the conference.
Would you like further help on specific sections of these documents?
Yes
Case Rating: *
Hey ****! For the specific sections of these documents:
- Appeal: Make sure to clearly explain why you disagree with the adjuster's decision and provide any new evidence supporting your claim.
- BRC Form-*: Include all relevant details about your injury, the disagreement, and any supporting evidence.
Would you like assistance with any particular section of these documents?
Yes
Case Rating: *
Hey ****! For detailed assistance with specific sections of your documents:
- Appeal: Clearly explain why you disagree with the adjuster's decision and provide any new evidence.
- BRC Form-*: Include all relevant details about your injury, the disagreement, and supporting evidence.
Which section do you need help with first?