Appealing a Workers’ Comp Claim in Vermont: What You Need To Know

Facing a workers’ compensation denial can be frustrating and stressful. However, this doesn’t mean it’s the end of the road to seeking the benefits you deserve. In Vermont, you can challenge the denial through an appeals process if you feel it’s unfair. Understanding the appeals process is crucial as this can help you take the proper steps toward securing the compensation you deserve. In this article, we explore what you need to know about appealing a worker’s compensation claim in Vermont.

Understanding the Denial

Once you receive the denial, it is essential to understand why your claim was rejected. Typically, insurance adjusters are required to provide a written explanation outlining the reasons for the denial. For instance, the reason for the denial could have been a lack of sufficient evidence or disputes over whether the injury was work-related. Read the denial notice carefully, and if the reasons are inaccurate, gather evidence that disproves them.

Consulting With an Attorney

Although you can handle the appeal without legal help, consulting a Vermont workers’ compensation attorney can significantly improve the chances of success. The attorney can review your case, gather the necessary evidence, and represent you in subsequent hearings.

Filing an Appeal

The appeals process starts with filing a Notice of Intention to Appeal with the Vermont Department of Labor (DOL). This notifies the department and the insurer that you are challenging the denial. Once you file, the DOL will schedule an informal phone hearing where you, your attorney, and the insurance company present your case.

After the hearing, the DOL will issue a written decision. If you disagree with the decision, you can request a formal in-person hearing. However, before the formal hearing, most workers’ comp disputes must go through mediation if they are not resolved after the informal hearing. The mediation must take place at least 30 days before the formal hearing, where both parties try to negotiate a settlement. Even if you hadn’t hired an attorney before this point, you can work with one specifically for mediation. During the formal hearing, which is similar to a trial, you get the opportunity to present evidence supporting the case, including eyewitness testimony, medical records, and expert opinions. Most cases end up being resolved at the mediation or formal hearing stage.

However, suppose you’re still unable to secure the benefits after the formal hearing or mediation. In that case, you may appeal the decision to the Vermont Superior Court or the Vermont Supreme Court based on the nature of the dispute. These courts will review the case and issue a final ruling.

Time Limits for Filing a Workers’ Comp Claims Appeal

Strict deadlines apply when appealing a workers’ compensation denial. In Vermont, you must file a notice of appeal within 30 days from the date of the denial decision. Missing the filing deadline can jeopardize your chance of challenging the denial. It is best to work with an experienced workers’ comp attorney who can ensure all paperwork is submitted on time and in the correct format.

Contact an Experienced Vermont Workers’ Compensation Lawyer

If your workers’ comp claim has been denied, contact our experienced Vermont workers’ comp lawyer at Sluka Law PLC at 802-457-1000 today to help you build a strong case and fight to secure the benefits you deserve.

Source:

legislature.vermont.gov/statutes/section/12/102/02383#:~:text=Except%20as%20otherwise%20provided%20by,or%20any%20political%20subdivision%20thereof.