Hearings and Appeals Process

Chattanooga Workers’ Compensation Lawyers Helping Clients Whose Claims Have Been Denied

Skilled representation in hearings and through the appeals process in Tennessee and Georgia

You sustain an injury while working, and file your claim for workers’ compensation benefits. You’re pretty sure you followed the rules correctly, and you know you’re injured because of something at work – yet your claim is denied, and you don’t know why. What do you do next?

You call Wagner Workers Compensation & Personal Injury Lawyers. Since 1945, we’ve been representing injured workers in Chattanooga, Cleveland, and across Tennessee and Northern Georgia. Our team of attorneys understands the ins and outs of workers’ compensation claims, and we know what to do when you’ve tried filing a claim on your own, or with the help of someone else, and that claim is denied. Let our family help yours by representing you in hearings and in the appeals process for your benefits.

Why did my claim get denied?

There are a lot of reasons why the Bureau of Workers’ Compensation (in Tennessee) or the State Board of Workers’ Compensation (in Georgia) might deny a claim, but these are the most commonly cited:

You didn’t tell your boss you were hurt
You didn’t go to the doctor
Your claim was filed after you were no longer working at your job
Your medical reports don’t match your description of the type of injury you have
Your doctor’s report doesn’t indicate that the injury is work-related
No one saw the injury occur, and no injury report has been filed
There is no one major, traumatic incident that led to your injury
You refused to work with the insurance company
Your medical reports indicate there were illegal drugs in your system

The importance of telling your boss if you were injured while working

Remember, you only get 30 days to tell your employer if you were hurt. If you don’t say anything, your claim could be barred or denied.

Here’s a pretty common scenario that can lead to complications with a claim:

Imagine you’re working and you fall. You bruise your ankle and it hurts, but you go home, wrap it up in an Ace bandage, and take a day or two off of work before you go back. You waive off filing for workers’ comp, because you don’t feel that injured, and you don’t see a doctor or talk with the insurance company. After a week or so, you barely notice any discomfort.

A few months later, one of your coworkers smacks into your ankle with a forklift, and that’s that: the pain is excruciating, and you can barely walk. This time, you seek medical attention – but now, you have a pre-existing injury that went unreported, so you’re only granted compensation for the new injury, not the pre-existing damage to your ankle.

You can lose out on the benefits you are entitled to receive if you let work injuries go unreported. In some cases, you may be denied benefits altogether. That is why you want an attorney from our firm on your side.

Next steps if your workers’ compensation claim has been denied

If your claim is denied, you can dispute the denial. First, we file a Petition for Benefits Determination with the Tennessee Bureau of Workers’ Compensation. You only have one year to file that claim from the day you were hurt, the last day or your medical treatment, or when you stopped receiving benefits from your employer. In cases where the injury was fatal, families only have one year from the date of the worker’s death to file the claim.

The next step is mediation – the Benefit Review Conference, or BRC. You, your attorney, the workers’ compensation insurer and a third-party neutral mediator will sit down and resolve your disputes, usually within a 3-week timeframe. If you reach a decision that is beneficial to both parties, then the dispute is over. If you cannot reach a settlement, then you move onto the next phase: a hearing at the Tennessee Court of Workers’ Compensation Claims.

Requests for a hearing must be submitted within 60 days, and the initial hearing should be set for within the next 30 days. A judge will review evidence presented from both sides, and then render a decision.

In Georgia, the process is slightly different, because there is no mandatory mediation. If your claim is denied, we file a WC-14 form to request a hearing. That hearing will be scheduled within 60 days of the receipt of the request.

In either state, if the hearing does not go in your favor, then we can file an appeal.

Appealing a decision about your workers’ compensation benefits

In Tennessee, you can ask the Board of Workers’ Compensation Appeals to review your claim within 30 days of the judge’s order. During an appeal, a panel of three judges review what was presented to the Tennessee Court of Workers’ Compensation Claims; they won’t consider any new information or testimony. If they affirm the decision by the Court, then your next and only option is to appeal to the Tennessee Supreme Court. If they disagree with the decision, then they might modify the order.

In Georgia, you only have 20 days to appeal the decision, and your case goes to the Appellate Division of the State Board of Workers’ Compensation. If the Appellate Division upholds the lower Court’s ruling, then you can appeal to Georgia Superior Court within 20 days. If they side with the Appellate Division, then your next and only option is to appeal to the Georgia Court of Appeals within – you guessed it – 20 days.

Regardless of which state you want to file an appeal in, though, you should know that the further along in the process you get, the harder it becomes to launch a successful appeal. You need an experience trial attorney who had represented clients in appeals before, and who understands exactly what is on the line. At Wagner Workers Compensation & Personal Injury Lawyers, you’ll find Chattanooga workers’ compensation lawyers who not only care about the outcome of your case, but know what it takes to get you the best possible outcome, form the start.

Helping injured workers through hearings and appeals

At Wagner Workers Compensation & Personal Injury Lawyers, we know you’re hurting and frustrated. You’ve been through the ringer trying to get the benefits you need and the care you deserve. Let our workers’ compensation lawyers handle the heavy lifting from here on out. To schedule your consultation, please call 423-756-7923 or fill out our contact form. We serve clients in North Georgia; Cleveland and Chattanooga; and all surrounding counties.