A denied workers’ compensation claim can leave you wondering how you will pay medical bills or cover lost wages. That uncertainty does not mean your case is over. Connecticut law gives injured workers a path to challenge a denial and pursue benefits.
Why claims get denied
Insurance companies and employers deny claims for several reasons. Some involve paperwork problems. Others involve disputes about the injury itself. Common reasons can include:
- Missed deadlines: State law sets strict filing windows and a late claim can be rejected.
- Incomplete information: A missing form or unclear medical detail can stall a claim.
- Disputed cause: Your employer may argue the injury was pre-existing or unrelated to your job.
- Worker classification: Being labeled an independent contractor instead of an employee can affect eligibility.
The stated reason for denial can help you figure out what evidence might address it.
Requesting an informal hearing
Your first step after a denial is usually to request an informal hearing with the Workers’ Compensation Commission. This step lets you present your side of the dispute. You can read more about the district offices that handle these hearings across the state.
A commissioner reviews the case and hears from both you and the insurer. The case often settles at this stage without moving further.
Moving to a formal hearing
If the informal hearing does not resolve things, you can request a formal hearing. This process resembles a trial, where both sides present medical records and witness statements.
An administrative law judge then issues a binding decision. If you disagree with that outcome, Conn. Gen. Stat. § 31-301 allows an appeal to the Compensation Review Board. You have only 20 days from the decision date to file that appeal.
Strengthening your case along the way
Ongoing documentation can matter as much as your initial claim. Continuing medical treatment shows your injury is still active.
Records of doctor visits and missed work can also support your position if the dispute continues.
Moving forward after a denial
A workers’ comp denial often comes down to paperwork issues, disputes over how an injury happened or disagreements about its severity. Connecticut’s appeals process gives you a way to respond at each stage, from an informal hearing through a possible appeal to the Compensation Review Board.
If your situation involves a formal hearing or an appeal, a workers’ compensation attorney may help you understand your options.