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Brannock & Soto Workers' comp lawyers
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Denied claims and appeals

A denial letter is the insurer's opinion, not a judge's decision. We find out why it said no and what it takes to change the answer.

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Denied or cut off

Why claims get denied

Insurers deny workers' comp claims for many reasons. Some are paperwork: the injury was reported late, a form went to the wrong place, or a doctor's note did not say the injury came from work. Some are fights over facts: the insurer says your back problem is old, or that you were hurt at home, or that you are able to work.

We start by getting the claim file and reading the denial the way the insurer's lawyer will. Then we tell you plainly whether we think it can be challenged, what proof is missing and how long the next step usually takes in your state.

Most denials are not the end of a claim. They are the start of the part where evidence matters.

You may be in this spot if

  • You got a letter saying your claim is denied or "not compensable"
  • Benefits started, then stopped without a clear reason
  • The insurer says your injury is from an old condition or from outside work
  • Your employer says you reported the injury too late
  • The insurer's doctor says you can work, but your own doctor disagrees

How we help

  • Read the real reason

    We request the claim file, adjuster notes and medical reports, not only the letter, so we know what the insurer is relying on.

  • Build the missing proof

    That can mean a clearer report from your treating doctor, witness statements from co-workers or a second medical opinion.

  • Ask for a hearing

    If talking does not fix it, we file for a hearing before a workers' comp judge and prepare you for every question.

  • Protect the clock

    Appeals have their own deadlines, often short. We put them in writing for you on the first call.

Common denial reasons, and what usually answers them

These are patterns, not promises. What works depends on your records and your state's rules.

Common denial reasons, and what usually answers them
The insurer says What often helps
The insurer says"You reported the injury too late." What often helpsProof you told a supervisor earlier, texts, schedule changes or a state rule that excuses the delay.
The insurer says"It's a pre-existing condition." What often helpsA doctor's opinion that work made the condition worse. In many states that can still be covered.
The insurer says"It didn't happen at work." What often helpsCo-worker statements, timecards, the first medical record and what you told the clinic that day.
The insurer says"You can go back to work." What often helpsYour treating doctor's written restrictions, compared line by line with the job you are offered.
The insurer says"You missed an appointment." What often helpsA record of why, and a fast reschedule. Missed exams are fixable more often than people think.

Deadlines, in general terms

Deadlines to challenge a denial are set by each state and can be short, sometimes only weeks from a decision. Call before you assume you still have time.

Every state writes its own deadlines. We give you the dates that apply in Missouri and Kansas in writing after the first call. What varies by state

A related example outcome

Example outcomes are illustrations written for this sample website, not real clients. Every case is different. Past results do not guarantee or predict a similar result in any other matter, and some cases do not succeed.

All example outcomes

Example outcome Denied claim

Denied back claim reversed after a hearing

Warehouse order picker

The situation
The insurer denied a lifting injury as "degenerative" because an MRI showed age-related wear in the lower spine.
What we did
We got a written opinion from the treating spine doctor comparing older records with the new scan, and statements from two co-workers who saw the lift.
How it ended
The judge found the injury work related. Medical care, including physical therapy, was approved and past-due wage benefits were paid.

Went the client's way

Questions we hear

All questions
Can I still get medical care after a denial?

Usually you can use your own health insurance in the meantime, though some plans push back on work injuries. If the denial is later reversed, many states require the comp insurer to repay those bills. We help you keep track of every bill so nothing is lost.

Is it worth fighting a denial?

Sometimes yes, sometimes no. We look at the medical records and the reason for the denial and tell you honestly. If we don't think the claim can be won, we say so and explain your other options.

How long does an appeal take?

It depends on your state and how busy the hearing calendar is. Some disputes settle in weeks once records are sent; others take many months to reach a hearing. We give you a realistic range after we see the file.

Other ways we help

Talk to a lawyer about your denied claim

The free case evaluation takes about five minutes. We call back within one business day, in English or Spanish, and tell you plainly whether we think we can help.

Start a free case evaluation Call (816) 555-0142

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