How Many Times Can You Appeal a Workers’ Compensation Case?

Workers’ compensation is supposed to provide benefits to employees who are injured on the job. While employees aren’t required to prove that their employers were negligent in order to recover benefits, many claims are still denied by insurance companies. It can be highly frustrating for workers when their claims are denied. However, you can appeal a denial of your workers’ comp claim. One study found that 67 percent of denied claims are ultimately accepted on appeal. So, how many times can you appeal a workers’ compensation case in Missouri? Scroll down to find out.

How Many Times Can You Appeal a Workers’ Compensation Case in Missouri?

Is the insurance company denying your claim and refusing to settle? How many times can you appeal a workers’ compensation case in Missouri?

First, remember that having an insurance company initially deny your claim does not mean you will lose it on appeal. Missouri law provides you with the right to appeal the insurance company’s decision and have an evidentiary hearing. If you lose the evidentiary hearing, you will again have the right to appeal the final decision within 20 days.

Let’s take a look at the appeals process for workers’ compensation claims in Missouri.

Evidentiary Hearing

Following the insurance company’s denial of your claim or refusal to offer a fair settlement, you can request an evidentiary hearing. An administrative law judge (ALJ) will preside over the evidentiary hearing. Both you and the insurance company can present evidence and facts at this hearing, and the ALJ will issue a decision on whether to award your claim. Once the decision is final, you or the insurance company can file an appeal within 20 days to the Labor and Industrial Relations Commission (LIRC).

Appealing Temporary Awards

You won’t be able to appeal a decision granting you a partial or temporary award. However, the insurance company can appeal the ALJ’s decision to grant your partial or temporary award.

Appeal from the Evidentiary Hearing

Following the evidentiary hearing, you or the insurance company can appeal the ALJ’s final decision to the Labor and Industrial Relations Commission. The appeal is reviewed by a panel of three judges. They will review the transcript from the evidentiary hearing. Your attorney will file a brief with the LIRC and can ask for the opportunity to argue your case before the panel. However, you won’t receive a new hearing or have the ability to present new evidence. The brief your attorney will file will outline your arguments and the evidence. Once the panel reviews the written arguments submitted by your attorney and the insurance company, along with the transcript from the hearing, they will make a decision. This decision will either agree with the ALJ’s ruling or issue a new one.

Appealing to the Missouri Court of Appeals

If you are unhappy with the decision issued by the Commission, either you or the insurance company can appeal the decision to the Missouri Court of Appeals. However, this appeal is much more limited than your earlier appeals. Before you can file an appeal to the Missouri Court of Appeals, the appeal must first be approved by the Missouri Supreme Court. If your ability to appeal the decision is approved, the Missouri Court of Appeals will review the legal briefs and transcripts. It will only consider whether any legal errors were made and will not make new findings of fact.

Effect of a Settlement

In many cases, an insurance company will negotiate with an injured employee to try to settle the case. If you accept a settlement, however, you won’t have the ability to file an appeal. Agreeing to settle a workers’ compensation claim means that you accept the settlement terms and waive your right to appeal.

Get Help from a Workers’ Compensation Lawyer

If you are trying to settle with your employer’s workers’ compensation insurance carrier, but the company has either denied your claim or refuses to offer a fair settlement, you should speak with an experienced attorney at the Law Offices of Bryan Musgrave. We can help to guide you through the appeals process, represent your interests, and ensure the correct procedures and deadlines are followed. Call us today for a free consultation at 417-322-2222 (Springfield) or 417-624-4258 (Joplin). You can also contact us online.