Work injury lawyer comp discusses rules of evidence and why an employee should never appeal a denied workers’ comp claim on his or her own.
Our attorneys have over 75 years of combined experience representing people who have been denied workers’ comp benefits. We have seen all kinds of workplace accidents and recovered millions of dollars for our clients. How to appeal a denied workers’ comp claim is a common question that we get asked. This is our warning about representing yourself.
We have seen people use online resources to represent themselves in court. It never goes well and jeopardizes any valid claim they might have. One individual thought he had a valid legal argument simply because anonymous users on an Internet message board agreed.
Do not expect a magistrate to award workers’ comp benefits using common sense. Just because someone is right does not mean they can win at trial. Specific procedures must be followed, and the rules of evidence apply.
How to appeal a denied workers’ comp claim?
To appeal a denied workers’ comp claim you must file an Application for Mediation or Hearing (Form WC-104). This will start a formal process where a magistrate is assigned to the case. He or she will ultimately be responsible for deciding facts and law. It is possible to get an open award, closed award, or denial.
Below are some issues that people generally miss when they try to appeal a denied workers’ comp claim and why it is a bad idea to represent yourself.
Insurance company math is usually wrong
Disabled employees are supposed to be paid 80% of their after-tax average weekly wage subject to a state-wide maximum. This calculation includes money for overtime, discontinued fringe benefits, and even second jobs that cannot be performed. Our experience shows that insurance companies make mistakes, and they are never in your favor. It is critical to obtain actual wage records from the employer and do the math calculation yourself. Stipulating to a rate at trial could result in thousands of dollars being lost each year. Hire a professional and don’t leave money on the table by trying to appeal a denied workers’ comp claim by yourself.
Medical depositions are serious business
Start with getting medical evidence that supports causation and disability. A doctor will need to testify that a medical condition was caused by employment activities. This is not easy if preexisting conditions like arthritis exist. He or she must give work restrictions that can be used to establish disability. It is not good enough for a doctor to say that a person cannot do his or her job. Medical evidence is typically presented through depositions. Expect the insurance company lawyer to cross examine your doctor and present their own medical testimony showing opposite conclusions.
Secure vocational evidence that supports total disability
Insurance companies are permitted to use post-injury wage earning capacity (PIWEC) to reduce weekly checks. This is based upon “phantom wages” from jobs that might not exist. We have seen individuals have their wage loss benefits cut down to pennies on the dollar. Evidence of a good-faith job search must be presented at trial. It is also critical to hire a vocational expert to testify about the labor market and what jobs are possible within qualifications and training.
Prepare witnesses testimony for trial
When you appeal a denied workers’ comp claim an employee hurt on-the-job is going to have to explain what happened and how it has impacted his or her ability to work. This is not always simple when the rules of evidence limit what can be said or presented. It is also likely that a private investigator will testify regarding activity checks and video surveillance. Coworkers will be used to testify that events did or did not occur. All these witnesses must testify within the rules of evidence and be subjected to cross examination. Hire an experienced lawyer who can make sure witness testimony is appropriate.
Michigan Workers Comp Lawyers never charges a fee to evaluate a potential case. Our law firm has represented injured and disabled workers exclusively for more than 35 years. Call (844) 316-8033 for a free consultation today.