How to Navigate the Appeals Process for a Denied Federal Workers’ Compensation Claim

A group of men in suits looking at papers

A group of men in suits looking at papers

Navigating the Appeals Process After a Denial

Employees have come to expect workers’ compensation when they’re injured on the job. And this is for good reason—workers are protected under numerous laws and are often compensated for those losses. However, it’s not unheard of to have a federal workers’ compensation claim denied. If you’ve gone through the filing process and been met with disappointment, look to Aumiller Lomax. We take clients from all over the United States and help them appeal federal workers’ compensation denials. Our attorneys are at your side from start to finish. Find out how to handle a denial and begin the appeals process.

Understand Why You Were Denied

The first step in navigating the appeals process is to understand why your claim was denied. The Office of Workers’ Compensation Programs (OWCP) will provide a written explanation detailing the reasons for the denial. Here are a few common reasons why claims are denied:

  • The injury was deemed non-work-related
  • Your claim was filed too late
  • Inaccurate documentation
  • Incomplete records
  • Employer disputes
  • Inconsistencies between medical reports and claims
  • Lack of medical attention for the injury

Meet With an Experienced Attorney

When you’re met with a denial, reach out to the attorneys at Aumiller Lomax. While it’s possible to go through the appeals process without legal help, navigating the nuances of federal workers’ compensation law is challenging. We’ll work with you to gather additional evidence, correct errors, and clarify any misunderstandings. This second look could potentially lead to a successful appeal and acceptance of your cliam.

Start the Formal Appeals Process

If you receive  a denial from the OWCP, it’s time to begin the appeals procedure for denied federal workers’ comp claims. Cases vary from client to client, so consulting with an attorney and learning more about your specific situation is essential. Generally, your options to appeal a rejected federal workers’ comp claim are:

But you can only choose one type of appeal at a time.

  1. Branch of Hearings and Review (BHR)

You can ask for BHR to review your case by either:

  • Oral Hearing – A hearing officer will talk to you by phone (or rarely video). You’ll be able to explain your case.
  • Review of the Written Record – You don’t need to attend a hearing. Instead, you can send in a letter and documents (like doctor’s notes or arguments) to be reviewed.

You must ask for a hearing within 30 days of the decision.

  1. Reconsideration

You can ask the same office that made the decision to take another look. You’ll need to send a letter explaining why the decision was wrong, along with new evidence—like updated medical reports.

You must ask for reconsideration within 1 year of the decision. The request and supporting materials must be received by the OWCP within the year.

  1. Appeal to ECAB

You can ask the Employees’ Compensation Appeals Board (ECAB) to review your case. This is a higher-level appeal, kind of like a court review. They only look at the documents that were already in your file when the decision was made—you can’t send in new evidence.

You must file your ECAB appeal within 180 days of the decision.

Be aware that you can only choose one type of appeal at a time.

How to Prepare for an Appeal

The key to a success story? Plenty of preparation. Keep meticulous records of all correspondence, medical reports, and any other documentation related to your claim. Stay within the time limits for filing appeals, and make sure any additional evidence you submit is solid and relevant to your case. As you gather relevant documents, don’t forget the following:

  • The official denial letter
  • All medical records
  • Job description
  • Correspondence records
  • Witness statements
  • New evidence

Reach Out to Aumiller Lomax Today

As you navigate a denied federal workers’ compensation appeal, be sure to secure reliable legal representation. The team at Aumiller Lomax has experience representing clients from all over the United States, with particular success in the Northeast. We work tirelessly to get you the compensation you deserve, even if you need to go through the appeals process. Get in touch with us today to learn more about the viability of your case.