Workers’ Comp Claim Denied in Kentucky? Here’s What to Do
Workers’ compensation is not something you want to be in a position to need, but can provide valuable support if you are injured on the job. Workers’ compensation benefits can help cover lost wages, medical bills, and other potential costs tied to an incident.
But workers’ compensation claims are not always guaranteed to be accepted by an insurer. An insurance company’s goal often is to avoid paying more than they need to. If they see a feasible opportunity to deny a claim, they will likely take it.
If your workers’ comp has been denied, you will have a limited time to appeal the decision. Do not put off taking the steps you need to build your case. As longstanding workers’ compensation attorneys in Kentucky, Karl Truman Law Firm recommends the following.
Understand the Reasons Behind Your Workers’ Comp Denial
When the insurance company denied your workers’ comp claim, it should have sent you a letter explaining why your workers’ comp claim was denied. Common reasons why your workers’ comp claim may be denied include:
- A belief that the injury was not related to work or insufficient evidence that it was
- A belief that the injury is due to a pre-existing condition
- Your employer disputing your workers’ comp claim
- Inconsistencies in the documentation sent with your claim or clerical errors
- Reporting the claim after Kentucky’s notice and filing deadlines
- Not seeking medical care quickly enough according to the insurer, which provides them an opportunity to argue that your injury must not have been as serious as you claim
Regardless of the reason an insurance company provides for a denial, you have the right to file an appeal. Knowing the reasoning will help shape how that appeal should be made.
Contact a Workers’ Comp Lawyer as Soon as Possible
The denial letter should also provide a deadline for filing your appeal. In Kentucky and Indiana, you typically have 30 days to submit your appeal to a Workers’ Compensation Board.
While 30 days might feel like a lot of time, it can pass extraordinarily quickly when you are trying to build a strong workers’ compensation claim. To win your appeal and get fair compensation, you’ll need to understand state law, collect and review medical records, and negotiate with the insurance carrier. For many injured workers, that’s too much to handle on their own.
A Kentucky workers’ compensation attorney has the experience to know how best to proceed during the appeals process. An attorney can provide valuable support for an appeal in many ways, some that can go beyond the appeal itself. An attorney can:
- Review the denial letter with you, helping you understand the insurance company’s tactics and how to fight back
- Collect evidence, like medical records, that support your comp claim and help you talk with your doctors, co-workers, and other witnesses
- Serve as your point of communication and negotiator with your employer and the insurance company
- Calculate your past due workers’ compensation benefits and the settlement value of your workers’ compensation claim
- Connect you with doctors and other professionals, helping you get the medical treatment you need
In addition to working on your workers’ compensation appeal, an attorney might identify additional third-party claims you can make. For example, if your workplace injury was caused by faulty equipment or from the actions of a third party that works with your employer, claims could be made against the equipment manufacturer or partner company. Such claims could help supplement your workers’ compensation or serve as a replacement in the event a denial can’t be overturned.
Can You Handle a Workers’ Comp Claim on Your Own?
We don’t recommend speaking with your employer or the insurance company until you have had a chance to discuss your options with a workers’ compensation attorney.
While an attorney is not required for any meeting or conversation with involved parties (and the parties may tell you this), they might try to get you to say or admit to things that could damage your comp claim. What might seem like a simple or innocent statement could be used against you, and it is best to have an experienced workers’ comp lawyer on your side throughout your claim.
RELATED: 10 Workers’ Comp Adjuster Tricks to Avoid
Collect Evidence About Your Workplace Injury
As previously mentioned, a workers’ comp attorney can help you gather the evidence you will need to more successfully appeal. However, depending on the reason for the denial, there is evidence you might be able to start gathering before waiting for your attorney’s suggestions.
Some evidence to consider collecting before making an appeal (and really is worth collecting before your claim is even approved or denied in the first place) includes:
- Medical records related to your workers’ compensation claim
- Photos of injuries and the accident scene, as close to the incident as possible
- Recordings (written or video) of how your injuries have been affecting your daily life and ability to work
- Testimony from friends and co-workers describing changes they have noticed in you (physical or behavioral) after your accident
Additionally, if you are currently receiving medical treatment, follow it as precisely as you can. It is not only more likely to help with your recovery but also helps prove the sincerity of your injuries and your desire to heal.
What Does the Workers’ Compensation Appeal Process Look Like in Kentucky?
When your workers’ compensation claim is denied, it’s easy to feel like the system is stacked against you. But don’t lose hope—this is just the beginning of the process. With the right guidance, you can still fight for the benefits you deserve.
The first step after a denial is a Benefit Review Conference. Here, you and your lawyer will meet with representatives from your employer or their workers’ compensation insurance company to discuss your claim. It’s their opportunity to challenge your case, and your chance to prove your injuries and losses are real and deserving of fair compensation.
If an agreement isn’t reached at the conference, the fight isn’t over. The next step is a formal hearing before an administrative law judge. Think of this as your day in court—a chance to present evidence, provide testimony, and make your case in a more structured environment. The judge will carefully review the facts and issue a decision within 60 days.
What if Your Workers’ Compensation Appeal Is Denied?
If the judge denies your claim, you still have options. First, you can file a Petition for Reconsideration within 14 days. This is your chance to point out any mistakes or inconsistencies in the judge’s decision and ask them to reconsider.
If that doesn’t change the outcome, the case moves to the Workers’ Compensation Board, a three-member panel that reviews the record from your hearing. However, no new evidence can be introduced at this stage, and overturning a judge’s decision is difficult. The board will issue a decision within 60 days.
If the board affirms the denial, the final step is an appeal to the Kentucky Court of Appeals. While the chances of reversal at this stage are slim, it’s not impossible—and having a strong legal advocate by your side ensures every avenue is explored.
Finally, the insurance company may agree to a settlement. Rather than continuing to litigate your comp claim, the insurance carrier will pay you a lump sum of money. In exchange, you give up your right to any past-due or future workers’ compensation benefits that you might be owed.
Navigating these steps can feel overwhelming, but you don’t have to do it alone. For decades, I’ve been standing up for hardworking Kentuckians, helping them fight back against powerful insurance companies and employers who try to deny them what they’ve earned. If your workers’ compensation claim has been denied, let’s talk. Together, we’ll take the next step toward justice.
Contact Our No-Obligation Workers’ Comp Lawyers
Time is of the essence when addressing a workers’ comp denial, but that doesn’t mean you have to worry about being pressured into upfront costs or commitments.
Our workplace injury attorneys will review your case for free. If we believe we can help you, you will have nothing to pay out of pocket. We will cover any case or court fees up front and only get paid a contingency (up to a maximum fee) if we can get you the compensation you deserve.
The Karl Truman Law Office serves clients in and around Louisville, Kentucky, and Jeffersonville, Indiana. Please call (502) 222-222 today for your free consultation.
The content provided here is for informational purposes only and should not be construed as legal advice on any subject.