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What Are the Odds of Successfully Appealing My Cincinnati Workers’ Compensation Claim?

A set of dice forming the word claim.

Learning that your workers’ compensation claim has been denied is extremely frustrating. You assumed your employer would take care of you and they have not. The good news is that a seasoned workers’ compensation lawyer in Cincinnati can help.

Most Workers’ Compensation Claims in Cincinnati Are Approved

Believe it or not, most Cincinnati workers’ compensation claims are approved. It just doesn’t feel like it when you find out your claim has been denied. The first thing you’ll feel is anger. Then you’ll likely be afraid.

If you’re like most of our other clients, you can’t afford to go weeks or months without a paycheck. This is why it’s so important that your appeal be successful the first time around. The odds of this happening are much higher if you retain an experienced Cincinnati workers comp attorney.

Less Than 10% of All Workers Comp Claims Are Denied

On average, less than 10% of all workers’ compensation claims are denied. In fact, recent studies show that the number is only around 7%. This means that 93% of the claims were approved.

If you happen to fall into the 7%, your only option is to file an appeal. Of course, your workers’ compensation lawyer in Cincinnati can try to negotiate a settlement without filing an appeal. However, people who do this tend to walk away with a lot less money.

What Was the Nature and Extent of Your Workplace Injuries?

Whether your workers’ comp claim will be approved depends on the nature and extent of your injuries. If you fell at work and hurt your wrist, it probably won’t cost the insurance company a lot to pay your claim.

If, however, you suffer a serious injury, it could cost them hundreds of thousands of dollars. This is the kind of claim they want to deny. Even if you appeal your claim, there’s a good chance your Cincinnati workers comp attorney will settle for less.

It’s Also Common for Remote Workers’ Workers Comp Claims to Be Denied 

Other instances where our workers’ compensation lawyers in Cincinnati see claims being denied is with remote workers. When you work off-site, it’s a lot harder to prove that your injuries were work-related.

In our experience, remote workers have the hardest time getting their claims approved. There are no witnesses to your accident. Even if there were, they’d be your family and, therefore, extremely biased.

Your Cincinnati Workers Comp Attorney Will Need to Know Why Your Claim Was Denied

Before your Cincinnati workers comp attorney does anything, they need to see your letter of denial. The reason why your claim was denied is critically important. In fact, depending on the reason, an attorney may not be able to take you on as a client.

For example, if your claim was denied because you were under the influence of drugs or alcohol, an appeal will not be successful. No insurance company is going to pay a claim for someone who was drunk or high at work.

Was Your Claim Denied Due to a Technicality or Clerical Error?

Now, if your claim was denied for clerical reasons, it should be an easy fix. The insurance company may not be responding to you. But they will not ignore your workers’ compensation lawyer in Cincinnati.

When you come in for your free, initial consultation, make sure to bring all your paperwork with you. Your attorney will review your documentation and find out what you were missing. They will then work quickly to remedy that problem.

A man filing a workers' compensation claim in Cincinnati

Does Your Employer Doubt That Your Workers Compensation Claim Was Legitimate?

It can be difficult to win your appeal if your claim was denied for substantive reasons. Some of the more common reasons the insurance company may have denied your claim include the following:

  • They don’t believe your injuries happened at work
  • You have a pre-existing condition
  • Witness statements did not align with your own story of what happened
  • You have a history of filing workers’ compensation claims
  • You have only worked for the company for a few weeks or months

If the insurance adjuster decides to deny your claim, your Cincinnati workers comp attorney will work hard to win on appeal.

Your Workers’ Compensation Lawyer in Cincinnati Will Help You File Your Appeal

Our goal as your workers’ compensation lawyer in Cincinnati is to get you the benefits you deserve. If you truly were injured at work, then there’s no reason you should be penalized.

Sometimes, it just takes a little time to convince the insurance company to approve your claim. Other times, your attorney may have to file suit.

If Your Claim is Approved, You’ll Be Entitled to Benefits

Of course, if your claim is approved, you will receive your workers’ compensation benefits. In Ohio, your benefits are the same as in any other state. You’ll be entitled to medical coverage and replacement wages.

You need to keep in mind that you need to be out of work for at least 7 calendar days for your benefits to kick in. If you happen to miss more than 21 days, you’ll be paid retroactively for that first seven-day period.

Your Cincinnati Workers Comp Attorney Will Also Try to Negotiate a Settlement

While your appeal is being processed, your workers’ compensation lawyer in Cincinnati will try to negotiate a settlement of your claim. These claims settle more than you may think.

We’ve also found that people who settle after filing an appeal receive a significantly higher settlement than those who settle without filing an appeal.

Workers Who File an Appeal Before They Settle Receive a Much Larger Settlement

On average, workers who wait to settle until after their appeal has been filed receive about 34% more than other workers. If somebody agrees to settle before they file an appeal, the insurance company has less incentive to settle.

The good news is that your Cincinnati workers comp attorney is well aware of this. They also know that workers who retain an attorney receive about a third more than workers who handle things on their own.

Reach Out to One of Our Experienced Cincinnati Workers Comp Attorney Today

If your workers’ compensation claim has been denied, you need help. Your odds of winning your appeal are bound to be better if you have a Cincinnati workers comp attorney.

We do offer new clients a free, initial consultation. You can bet the insurance company will have a team of lawyers working for them. You should have someone in your corner as well.

Jay A. Bolotin is a partner at the injury law firm of Young, Reverman & Bolotin. Serving the people of Indiana, Kentucky, and Ohio, Jay dedicates his career to helping clients in the tri-state area obtain financial compensation after suffering serious injuries. He focuses his practice on cases involving car accidents, trucking accidents, dog bites and animal attacks, and other types of personal injury incidents.

Years of Experience: More than 25 years
Registration Status:: Active
Bar Admissions: Illinois, Kentucky, Ohio, Indiana, and Cincinati Bar Association