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The Workers' Comp Claims and Appeals Process

Seattle Workers' Compensation Claims Attorney

Washington Workers' Comp Benefits: Kirkland Denied Claim Lawyer

The workers' compensation claims process can be complicated and confusing to walk through alone. To ensure your Washington claim is handled properly the first time around, it is important to work with an experienced Seattle workers' compensation claims lawyer. Attorney James E. Sedney of the Law Office of James E. Sedney has over 35 years of experience pursuing benefit claims for individuals throughout the state. This experience can make a difference in your case.

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Whether you were injured on the job in a car accident or other personal injury accident, or if you believe you have developed an occupational illness, you should go to a doctor promptly. After you have seen the doctor, reach out to our experienced Seattle attorney to learn all the details regarding the workers' compensation claims process:

  • Initial claims: Your doctor actually has an obligation under Washington law to help you to file a claim for workers' compensation benefits, either to the Department of Labor & Industries (DLI) or to the third-party administrator for your self-insured employer. Your employer will receive a copy of this claim.
  • Investigation: Employers occasionally fight against a claim, stating that there was no injury or that the illness was a pre-existing condition. An investigator may come to your workplace to interview fellow workers and witnesses regarding the accident. You need someone on your side at this time who will be looking out for your best interests.
  • Response: You will receive an order from the governing agency informing you whether your claim has been accepted. If your claim is denied, we can help.

Pursuing Workers' Compensation Appeals for Denied Claims

All hope is not lost if your claim is rejected initially. Within 60 days of receiving written notice of the claim's rejection, you may appeal that decision. We confidently and skillfully represent persons with rejected claims.

There are generally two options to challenge what appears to be a mistaken rejection of a claim:

  • Request for reconsideration: We will review your claim file, analyze the evidence, obtain additional evidence from your doctor, if necessary, and write to DLI to request reconsideration of the claim denial. The DLI will then issue a new order affirming the decision or reversing the original order. 
  • Appeal to the Board of Industrial Insurance Appeals: This is a more formal process that will include a mediation conference and potentially an administrative court hearing. It can take up to one year to receive a result.

While you do not receive benefits while you are waiting for the Board's decision, the Board has the authority to order the Department of Labor & Industries or your self-insured employer to pay all benefits due from the first day of your injury or illness if you win the appeal.

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Do not risk having your initial claim or request for reconsideration denied due to inaccurate or incomplete paperwork. Call on an experienced attorney for the guidance you require. Contact us today to schedule your free initial consultation.