If your workers’ compensation claim is denied, you can appeal your denial through the Department of Industrial Accidents. If you decide to appeal you still need to communicate the following information:
- Date of injury
- The 1st calendar day of work missed
- The 5th calendar day of work missed
- The workers’ compensation insurance carrier
- The body parts affected and types of injuries
- What type of benefits you’re seeking
- How long you could possibly be out of work (if applicable)
- Where you initially went to receive treatment
- The name of the doctor currently treating you
If your workers’ compensation claim is denied, you will need 3 copies of Form 110. One copy for the DIA, one for the workers’ compensation carrier, and one for your own records (or for an attorney that you later decide to hire). Send your original signed Form 110 (Employee Claim) as well as one of the following documents that support your case to the DIA. Such documents include:
- Unpaid medical bills
- Medical reports
- Any reports that support how the accident occurred
- Any names of witnesses
- Any statements of witnesses
After appealing your claim and sending it to the DIA, it will be reviewed and they will do one of two things. The DIA will either send you a rejection letter (which states what information is missing or incorrect) or if your information is correct, you, your employer, and the insurance company will receive a notification. This notice is to set up a conciliation meeting to talk about your claim. Your employer is only getting this notification out of generosity and they aren’t required to attend unless told otherwise by the insurance company.
