Many workplace accident victims often ask how long do workers' comp appeals take in Alabama to help them decide whether they should embark on the process. But to find an answer to this, it is imperative to understand how the appeal process works in the state. That's where a workers' comp lawyer comes in.
Appealing a Workers' Compensation Denial in Alabama
Ordinarily, if you sustain an injury during working hours, you are entitled to workers' compensation. It means that your employer would have to pay you an amount of money that covers your medical bills, lost wages, and compensates you for the injuries suffered.
Injuries here can be temporary or permanent, and its nature will determine how much you get. Often, injured workers who genuinely deserve compensation fail to get it as employers and insurance companies find ways to get out of this responsibility.
When this happens, the only recourse is for the employee to appeal the denial. Unlike most states in the US, Alabama does not have an administrative court system that takes and looks into appeals.
There is no administrative official to decide whether the insurance company should approve your claim. The only option available is to file a lawsuit in a state court to contest the workers' compensation denial. The process is quite complex, and you will need an Alabama workers' compensation attorney's assistance.
How to Appeal a Workers' Compensation Denial in Alabama
As mentioned earlier, the only place you can appeal a workers' compensation denial to is a state court. However, if it is about medical benefits, you may appeal to the Alabama Department of Industrial Relations (DIR). We'll analyze the options one after the other.
A Civil Lawsuit Appeal
If you want to stand a chance of getting your worker's compensation awarded, you must institute an action for wrongful denial in an Alabama District Court. You have to file the lawsuit in your employer's district or the one where the accident occurred.
The lawsuit would be governed by the same civil procedure laws that apply to other civil cases. You will have to fill a complaint form where you will provide the necessary details of your claim. It must include why the insurer denied your workers' compensation request and why you are disputing the decision.
The insurance company will receive a copy of the complaint and file an answer if they wish to present a defense. The answer would deny your assertions and reinforce why they denied your claim.
Next, the court will give both you and the insurance company time to gather evidence to support your claims. The latter is referred to as “Discovery,” and afterward, you and the insurance company's representative will give oral testimony under oath (depositions).
After the above process, your case will get assigned to a judge. As a general rule, Alabama law does not provide for jury trials for workers comp cases. The only exception is if the insurance company accuses you of willful misconduct, that is, your negligence actions resulted in your injury.
Appeal to the DIR
The DIR's primary function is to hear and resolve disputes about medical benefits through its Ombudsman Program. The agency began operating in 1992 after Alabama passed a law giving it power for the preceding purpose.
The ombudsman would schedule a conference to receive evidence and consult with an independent medical expert before deciding. Any decision by the ombudsman is binding on both parties.
Note that if the denial of your workers' comp benefit is not on medical grounds, the DIR can't make a binding decision on your case. You will get mediation services, but the chances of the insurance company agreeing to it are slim.
What Is the Time Frame for a Work Comp Appeal?
If you filed your appeal as a civil lawsuit in a state district court, it might take months or years for the trial to run its course and the court to give a decision. This is because the appeal is subject to the court's calendar and the readiness of both parties.
An appeal to the DIR will take a shorter time because it does not involve many processes as a court case. When you appeal for a work comp case for total denial of your benefits, do it within two years, counting from the work-related accident date. If you received partial payment, commence the appeal from the date you received the last payment.
Consult a Workers' Compensation Attorney to Help With Your Appeal!
If your employer's insurance company denies your benefits, you need to consult a workers comp attorney at Mike Bell Accident & Injury Lawyers to help with your appeal. Contact us today for a free case review.