Did you apply for benefits from Wisconsin workers' compensation? If all of your claim or part of it was denied, you may wonder what steps you can take next. Here's the process if you decide to pursue your claim further.
If you haven't retained an attorney, this is the point in the process where many people seek out a lawyer's help. For those that want to proceed without one, an informal process will begin. The Alternative Dispute Resolution Unit will look over your claim and determine what issues are being disputed. They also want to be sure that you have supporting medical information for your claim. If it appears to the ADR staff that the issues with your claim can be taken care without a formal hearing, the insurer and you will both be contacted as the ADR tries to resolve your dispute.
If this process doesn't resolve the issues with your claim, then you can request to go before an Administrative Law Judge for a formal hearing. In order to request such a hearing, you must file an application that contains supporting medical information for your claim. It is not required that you have an attorney for this hearing; however, it is a legal proceeding and many people believe that an attorney would be helpful.
Should the ALJ resolve the issues surrounding your claim, a formal order will be issued that explains what conditions are necessary.
If the ALJ denies your claim, you can file an appeal to go in front of the Labor and Industry Review Commission. Should they deny your claim, then your appeal can go into circuit court.
Source: State of Wisconsin Department of Workforce Development, "Worker's Compensation - What Happens If My Claim is Denied?," accessed March 25, 2016