Defending Your Rights And Future And Seeking The Compensation You Deserve

What to do if your permanent total disability claim is denied: A guide to your next steps

On Behalf of | Apr 30, 2025 | Workers' Compensation

A denial on a permanent total disability (PTD) claim can be disheartening and stressful. However, a denial does not mean the end of the road. There are several steps you can take to appeal the decision and strengthen your case.

Review the reason for denial

Carefully read the denial letter to understand the reasons for the denial. It should outline why your claim was not approved, whether due to insufficient medical evidence, missed deadlines or other reasons. This can give you a greater understanding of how to respond to the denial.

Get guidance from an experienced attorney

Consider consulting with an attorney who specializes in disability claims. They can provide valuable insights and help you understand your rights and options for appeal.

Gather additional evidence

Gather more medical records, doctor’s notes, or new evidence to support your claim. This could include detailed reports from your healthcare providers or new medical evaluations. This evidence could be especially important if your initial denial was the result of insufficient evidence.

Keep all documents, correspondence, and records organized. This will help you track the progress of your appeal and ensure you have everything needed for your case.

Keep deadlines in mind

You have a limited amount of time to appeal a decision, and missing this deadline can jeopardize your ability to contest the denial. Make sure you file all necessary paperwork on time.

Request a redetermination

In many cases, you have the right to request redetermination. This involves a complete review of your application by someone who was not involved in the initial decision. They may decide differently from the first reviewer and approve your PTD claim.

Prepare for a hearing

If redetermination is not successful, you may request a hearing. This is your chance to explain your case in person to an administrative law judge. Be prepared with all necessary documents and be ready to explain your situation clearly.

It is possible to receive the benefits you need

Remember, a denial is not the end. Many people successfully appeal their permanent total disability claims by following the right steps and not giving up. By doing these things, you can improve your chances of getting the benefits you need.

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