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Workers’ Compensation Appeals in San Antonio

Although most (almost 80%) workers in San Antonio and across Texas do have access to workers’ compensation, it is required by law for employers to carry it. Texas is actually the only state that does not require employers to provide workers’ compensation for their workers.

Almost 95% of work accident claims are settled before developing into a lawsuit. In many cases, the risk of going before a judge is enough to make an insurance company to cooperate with a settlement. But what happens next in the event that you receive a Notice of Denial from your employer, and you believe you deserve further compensation?

Workers’ Compensation Appeals in San Antonio

When you file a workers’ compensation claim for injuries or damages accrued while you were on the clock, it has the chance to be denied. A denial may come from your employer or from the employer’s insurance company. There is a 90-day rule in place in San Antonio according to Texas law that requires a claim to be denied or accepted by the insurance company within 90 days. If either rejects your claim, you may appeal the motion to deny.

My Claim Was Denied: Now What?

In the event that your claim is denied, you should immediately contact your employer or their insurance carrier. A good first step to take is to see if perhaps there has been a mistake. Once you ensure the denial is correct, it is time to gather all available evidence, seek a San Antonio workers’ compensation lawyer, and pursue the appeals process, beginning with arbitration.

With workers’ compensation appeals, there is always an option for arbitration before the claim develops further. Arbitration involves waiving your right to a full hearing. It is typically settled quickly and permanently; that is, if you choose arbitration, be aware that it is the end of the road for your appeal. Beyond arbitration, there are four basic levels of appealing a workers’ compensation claim in San Antonio:

  • Benefit review conference:
    A benefit review conference is the initial, informal meeting between you and your employer (usually a company representative). Both parties meet with a review officer, will attempt to ascertain grievances, and hopefully come to an agreement.
  • Contested case hearing:
    In the event that arbitration does not settle your predicament, a contested case hearing may take place. In contested hearings, compiling medical receipts and all other bills related to your injuries, accounts from witnesses, and any other evidence are critical to strengthening your appeal. At the end, the Hearing Office who handles your case will present his/her evaluation of the case in writing.
  • Appeals panel:
    If you believe your claim has been mishandled during the previous case hearings for any reason, you have 15 days from the date from the contested case hearing to file an appeal of the Hearing Officer’s assessment. Your case will then in front of a Division of Workers’ Compensation Appeals Panel. At this level, you cannot submit any new evidence. If at this point you are still unsatisfied or under-compensated for your injuries, you can still take your case to court.
  • State court appeal:
    The final level of appeals will take place within the Texas state court system. Workers’ compensation claims can get pretty complicated, and this the final level of appeals in Texas. By the time your case reaches this level, legal guidance is crucial.
Our Lawyers Are Here for You

The sooner you file your claim following an accident on the job, the better your chances are of receiving full compensation without risk of denial or the need for an appeal. An important part of obtaining reparation is the victims’ own diligence, as the appearance of complacency may indicate to an insurance company that your injuries were not as serious as you claim.

If you or someone you love is fighting a workers’ compensation claim and unsure where to turn for answers, look no further than our lawyers in San Antonio to guide you through all things related to workers’ compensation and other third party claims. Our San Antonio work injury accident attorneys  are available over the phone anytime, day or night.

Especially if over 90 days have passed, your best opportunity for a successful appeal rests in proper legal guidance from an experienced lawyer. Fortunately, the attorneys at the San Antonio law firm of Carabin Shaw believe that every victim of a workplace injury deserves a chance at full compensation for their injuries.

Many people seeking these claims have never dealt with the workers’ compensation appeals process in San Antonio before. Our lawyers are here to help you assemble the facts and maximize your opportunity to obtain full restitution. Call our San Antonio office today at 210-222-2288, or day or night, toll-free, at 800-862-1260.

Visits with the Attorney are by appointment only. Main office San Antonio, Texas.

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