WHAT IS A CONTROVERTED CLAIM?
A controverted workers’ compensation claim means that your employer or insurer intends to deny all or part of your claim. If your employer/insurer denies your entire claim, they will refuse to pay you lost wage benefits and will not pay for medical care.
There are many reasons why your employer may controvert your entire claim. Some of the more common reasons are:
- they contend that you were not injured while performing a job task
- they contend that you had a pre-existing injury that was not disclosed at hiring
- they contend that you were injured due to “horseplay”
- they contend that there was no accident at all and that you are faking the entire claim
- they contend that you failed to give proper notice of your claim within the 30 day time limit
HOW WE HANDLE CONTROVERTED CLAIMS
If you case is controverted, there is a good chance that we will immediately request a hearing before the State Board. If your case goes to hearing, we will introduce evidence to show that your injury was compensable and that you should be paid lost wage benefits dating back to the day of your injury, and that all current and future medical treatment should be paid by your employer.
Sometimes controverted claims make it to court and are heard by a State Board judge. More often, however, we will be able to resolve your case by settling your claims. Sometimes, we will be able to convince your employer’s insurance company to accept liability for your claim. In other cases, we will negotiate with the insurance company to settle all claims in what is known as a no liability stipulation. In a no liability settlement, your employer continues to deny that your work injury was legitimate, but they agree to pay you a lump sum.
WHY CONSULT WITH US
At Pasley, Nuce, Mallory & Davis, LLC, we have dedicated attorneys with known workers’ compensation knowledge and experience to help with your controverted claims. Contact us at any of our four locations for a free consultation to see how we can put our experience to work for you.