Merrillville Workers’ Compensation Attorneys
How Can a Workers’ Compensation Lawyer in Merrillville, Indiana Help Me Appeal a Denied or Underpaid Workers’ Comp Claim?
The workers’ compensation lawyers at Marshall P. Whalley & Associates can help you appeal a denied or underpaid workers’ compensation claim. Our attorneys can review your case, identify the reasons for denial, and assist you with the next steps. Workers’ compensation claims can be denied for many reasons. Sometimes these denials are due simply because workers’ compensation didn’t receive the proper documentation or support for the claim. In other cases, the denial is the result of more complex issues with the case including:
- Issues with pre-existing conditions. Sometimes, individuals with common injuries like back injuries or neck injuries might get pushback from workers’ compensation adjusters. The burden of proof might be higher to prove that your injury was worsened or started on the job. The workers’ compensation lawyers at Marshall P. Whalley & Associates in Merrillville, Indiana can help you make your case.
- Failure to meet deadlines or reporting requirements (in some cases these deadlines can be waived or adjusted, especially if your work injury was due to a work illness or if your injury wasn’t immediately diagnosed, or if you were comatose or otherwise unable to report your injury due to your medical condition).
- Claims that the accident happened off the clock. If workers’ compensation claims that your accident happened off the clock or wasn’t the result of you performing your work duties, the workman’s comp lawyers in Merrillville, Indiana at Marshall P. Whalley & Associates can help.
- Intoxication or drug use. If your employer or workers’ comp adjuster claims that your injury was the result of your intoxication or drug use, you have rights. Sometimes drug or alcohol tests can produce inaccurate results, especially if a person has certain medical conditions or is on medications. The workmans’ compensation lawyers in Merrillville, Indiana at Marshall P. Whalley & Associates can help you make your case and prove your innocence.
- Lack of medical care. If you didn’t seek appropriate medical treatment or follow-up care, your workers’ compensation claim might be denied or underpaid due to underdiagnosis or no diagnosis. In this case, your workers’ compensation lawyer can evaluate your case, and help you seek in-network medical care to move your claim forward.
- Improper worker classification. If you were improperly classified as an independent contractor or placed in a worker category that is exempt from workers’ compensation insurance, you might have been told that you don’t even have the right to make a claim at all.
These are just some of the factors that can lead to an underpaid or denied workers’ compensation claim. If you fail to provide adequate documentation or proof of disability, or fail to receive proper follow-up care, your workers’ compensation insurance adjuster may not be able to properly assess the level of disability you should be awarded from workers’ compensation. For example, permanent total disability designations aren’t usually made right away. Workers’ compensation gives individuals time to achieve full recovery. This means that receiving a permanent total disability designation from workers’ compensation is a process. If you were seriously injured on the job, the workers’ compensation attorneys in Merrillville, Indiana at Marshall P. Whalley & Associates are here to help you navigate the workers’ compensation insurance claims process.
How Can Workers’ Compensation Attorneys in Indiana Fight for Your Benefits?
Trustworthy attorneys appeal claim denials and disability assessments
State law requires employers to provide workers’ compensation insurance to cover work-related injuries starting on the first day of employment, even if your own carelessness caused the injury. However, getting your employer’s insurance provider to pay benefits is often a complex and stressful process. Marshall P. Whalley & Associates, PC, located in Crown Point, Indiana, assists with denied claims. Our attorneys have in-depth knowledge of the workers’ compensation appeals process from more than 30 years of representing injured workers. We can help you seek the full amount to which you’re entitled for damages including:
- Medical bills
- Temporary total disability
- Permanent total disability
- Permanent partial disability
- Death benefits
- And More
Contact the workers’ compensation lawyers in Merrillville, Indiana at Marshall P. Whalley & Associates today. We can review your case and guide you on the next steps. We fight for workers’ rights.
What is a work-related injury for the purposes of workers’ compensation?
Courts have defined “work-related” to mean an injury sustained “in the course of” and “arising out of” a worker’s employment. The specific facts of your case are very important. Here are some examples of what might be considered work-related injuries:
- Travel — A salesperson is covered for injuries occurring on the road, unless the insurer shows that the injury occurred on an unauthorized detour purely for personal benefit.
- Commuting — Personal injuries on the way to the office are not work-related, unless the company has provided a mode of transport (such as a van pool) for the benefit of the company.
- Lunch hour — Accidents on lunch breaks are usually covered, if the employee eats at a company facility.
- Break time — Regularly scheduled breaks are a work activity; these injuries are generally covered.
- Work party or office picnic — There are many factors to consider, such as whether the party was on company premises and whether attendance was widely viewed to be mandatory.
- Horseplay — Whether you are covered may depend on the company’s written and unwritten policy regarding such activity. It also depends on whether your actions are negligent, reckless or deliberate. You are not covered for deliberately inflicting an injury upon yourself.
If your workers’ compensation claim has been denied because either your employer or the workers’ compensation adjuster is disputing whether your injury is work-related, the workers’ compensation lawyers in Merrillville, Indiana at Marshall P. Whalley & Associates can help. Our workers’ compensation attorneys can review the details of your case, fight back when workers’ compensation underpays or wrongfully denies a claim, and help you take the next steps.
How can I get the maximum benefit allowable under workers’ compensation?
Workers’ compensation pays for medical bills and provides disability benefits for the period of time you’re unable to work. Controversies arise when doctors chosen by the employer make an assessment of the injury that does not reflect its true severity. For instance, if you are unable to work for 21 days, workers’ comp pays benefits for the eighth through the twenty-first day. However, if you are still unable to work on the twenty-second day, workers’ comp picks up the first seven days as well. If you’re still unfit, but the doctor clears you to work on the twenty-second day, you lose seven days of benefits. Marshall P. Whalley & Associates fights for the maximum benefits allowed.
How Do I Appeal a Denied Workers’ Compensation Claim in Merrillville, Indiana?
The first step in appealing a denied or underpaid workers’ compensation claim in Indiana is to attempt to resolve the issue through the informal dispute resolution process. The Workers’ Compensation Board of Indiana typically doesn’t hear cases until alternative dispute resolution processes have failed. Individuals and their workers’ comp lawyers in Merrillville, Indiana at Marshall P. Whalley & Associates can initiate the alternate dispute resolution process by completing a Request for Assistance form (State Form 45442). The board will then make an inquiry into the situation and see if there is a way that the issue can be resolved. The goal with alternative dispute resolution is to work out a satisfactory resolution without requiring a hearing.
It can be helpful to have a workman’s comp lawyer in Merrillville, Indiana at Marshall P. Whalley & Associates help you navigate the alternate dispute resolution process. Our workers’ comp attorneys can determine whether the resolution offered through the process is sufficient or whether it makes sense to initiate the formal hearing process.
According to the Workers’ Compensation Board of Indiana, some common disputes that can be handled by the alternate dispute resolution process include:
- Billing issues
- Discrepancies and delays in temporary total disability payments and temporary partial disability payments
- Disagreements over claim denials
- Disputes about injury severity
- Insurance issues
- Termination of benefits
- Proof of coverage issues
- Failure to report disputes
- Unpaid medical bills
If your claim cannot be resolved through alternate dispute resolution, you have two years to initiate a formal hearing process. The hearing process is similar to a court case, with each party presenting their evidence to the board. If the outcome of the hearing isn’t the one desired, individuals have the right to appeal. The process can sometimes be quite involved but may be worthwhile to pursue, especially if you were seriously injured in a work accident or have been totally and permanently disabled as a result of a work injury. If you have questions about the next steps you need to take to appeal a denied or underpaid workers’ comp claim, reach out to the workman’s comp lawyers in Merrillville, Indiana at Marshall P. Whalley & Associates today. We are here to help.
See our knowledgeable attorneys regarding workers’ comp
Marshall P. Whalley & Associates, PC understands the workers’ compensation systems in the states in which it is licensed. We are fully committed to helping you obtain the maximum benefits for your injury. For a free consultation and case evaluation, call 219.769.2900 or contact our Crown Point office online.
