What happens if my claim is denied?

What happens if my claim is denied?

Appealing Your Workers’ Compensation Claim in Wisconsin

If your workers’ compensation claim was denied, you may be worried about how you’ll pay your medical bills and support your family while you get better. But a denial isn’t the end of the process. At Sigman, Janssen, Sewall, Pitz & Hodgkiss, we can investigate the reasons your claim was denied and help you take the steps necessary to get your benefits.

Sigman Janssen has been helping people in Wisconsin for more than 85 years, and we want to put our experience to work for you. Contact our legal staff today to find out how we can help you get your workers’ compensation claim approved—just dial (800) 775-1441 or complete a free initial consultation form today.

Appealing Your Workers’ Compensation Claim Denial

If your workers’ compensation claim was denied or partially denied, there are four steps you can take to help get your benefits:

  1. Informal Alternative Dispute Resolution (ADR)

    If your workers’ compensation lawyer believes your claim can be settled through ADR, your claim will be referred to a specialist in the Division of Workers’ Compensation ADR Unit. If he or she believes your claim can be resolved without a formal hearing, your attorney and the insurance company will attempt to resolve the issues that caused your initial claim to be denied.

  2. Formal Hearing

    If your claim cannot be resolved through the informal ADR process, you may request a formal legal hearing with an Administrative Law Judge (ALJ). The ALJ will review evidence submitted by you and your work comp insurer and issue a decision based on his or her findings. The ALJ’s decision is a formal order that must be adhered to by all parties participating in the hearing.

  3. Appeal to the Labor and Industry Review Commission (LIRC)

    If you believe the decision issued by the ALJ presiding over your formal hearing was incorrect, you can appeal your claim to the LIRC. The LIRC will review your case and issue a decision based on your findings.

  4. Circuit Court Appeal

    If you disagree with the decision handed down by the LIRC, you can file an appeal with the circuit court.

Don’t Risk Your Benefits

You don’t have to go it alone if you’ve been denied the workers’ compensation benefits you need. At Sigman Janssen, we know Wisconsin law, and we won’t stop fighting until you get the best possible results for your claim. Contact our legal staff today to get the experienced representation you deserve.

Get Help!

Sigman, Janssen, Sewall, Pitz & Hodgkiss
303 S. Memorial Drive Appleton, WI 54911
(920) 731-5201