Denials, Disputes & Appeals
A denial is the beginning of the process, not the end: why claims get denied and how to answer each reason, what happens at a workers’ comp hearing, surveillance and social media, whose doctor wins when the medical opinions conflict, how to appeal, and what to do if you are accused of fraud.
All Denials, Disputes & Appeals guides
- Mediation in a Workers' Comp Case
What actually happens at a workers' comp mediation, who's in the room, what drives the numbers, and why you never have to settle.
- Workers' Comp Claim Denied: What to Do
Workers' comp claim denied? Learn common denial reasons, the IME process, appeal steps, and deadlines to act on now.
- How to Appeal a Workers' Comp Decision
The workers' comp appeal ladder from denial to court, why the deadlines at every step vary by state, and how the federal, maritime, and railroad systems differ.
- The Workers' Comp Hearing: What to Expect
A plain-English walkthrough of what actually happens at a workers' comp hearing, from the informal conference to the written decision and appeal.
- Changing Doctors or Changing Lawyers in a Comp Case
Feeling stuck with your work-comp doctor or lawyer? Here's how to switch either one the right way, without losing benefits.
- Can Your Employer Make You See Their Doctor?
Whether your employer picks your workers' comp doctor depends entirely on your state. Here's the framework and what to check first.
- Workers' Comp Fraud Accusations: What You Need to Know
Accused of workers' comp fraud, or worried about it? Here's what actually counts as fraud, what doesn't, and what to do next.
- The Comp Deposition: What to Expect
What really happens at a workers' comp deposition: who's there, what they'll ask, and the honesty rules that protect your claim.
- Apportionment: When They Blame Your Prior Injury
Apportionment lets a workers' comp insurer split your permanent disability with an old injury or a pre-existing condition. Here's how it works and how to respond.
- Representing Yourself at a Workers' Comp Hearing
You can represent yourself at a workers' comp hearing. Here's the free help available from state agencies, how to prepare, and when to get a lawyer instead.
- Surveillance and Social Media in Workers' Comp
Insurers can often film you in public and read your public posts while a workers' comp claim is open. Here's how it generally works, and how to protect yourself.
- When the IME Doctor Disagrees With Your Doctor
When an insurer's IME doctor contradicts your treating physician, here's how state workers' comp systems generally resolve the dispute and what you can do about it.
- Why Workers' Comp Claims Get Denied
The recurring reasons workers' comp claims get denied, the practical counter to each one, and the appeal deadline you cannot afford to miss.
- Intoxication, Horseplay, and Other Defenses to a Comp Claim
Insurers can raise a short list of defenses to a workers' comp claim - intoxication, horseplay, safety violations, personal deviations - but each is narrower than it sounds and must be proven.