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Not every claim presented to the Workers’ Compensation Commission is successful at first. A commissioner who reviews an injured worker’s claim may find that the injury was not compensable or that the injury occurred outside the scope of the worker’s job duties. This may require the services of a dedicated attorney.

If you were injured on the job and, after giving notice, received an unfavorable decision from a commissioner, you may be eligible for appealing a workers’ compensation decision in Winston-Salem through the two avenues of recovery still available to you.

Seeking a Decision Review

If an injured worker is dissatisfied with the outcome of the Commission, whether following a hearing or on the Commission’s own initiative, the worker has the right to apply for a review of the Commission’s award.

Specifically, under N.C. Gen. Stat. § 97-85 an injured worker has 15 days from the date when notice of the award was given to request a review. This request for review is made directly to the Commission. When a request for review is timely filed, all officials in the Commission, except for the commissioner who issued the award, will review the award to determine whether a rehearing is required or if additional evidence could have been helpful to the injured worker’s claim.

The commissioner who initially made the award is made exempt from the review to ensure objectivity. The Commission has broad discretion when reviewing a decision and their review may result in a favorable or unfavorable decision or no decision at all with a request that a rehearing be scheduled.

Appellate Review

If the request for an award review is not made in time or if the remaining commissioners find no error in the proceedings, an aggrieved injured worker may appeal the Commission’s decision to the courts for further review. According to N.C. Gen. Stat. § 97-86, the appeal must be filed:

  • No later than 30 days from the date of the Commission’s award
  • Accompanied by a filing fee

The specific court the appeal must be made to is indicated in civil appellate statute and determining the proper court may require the services of an attorney familiar with appealing a workers’ compensation decision in Winston-Salem. During the pendency of the appeal, it is important to note that any award of financial compensation in the award that is subject of the dispute will be placed on hold until the appeal is resolved.

Under N.C. Gen. Stat. § 97-86.1 if the appeal is made as to only certain parts of the award, the remaining parts would be unaffected. For example, if the Commission ordered the employer to pay causally related medical expenses and the appeal of the award is for issues other than payment of causally related bills, then payment would not be prohibited during the pendency of the appeal.

Appeal a Workers’ Compensation Decision with a Winston-Salem Attorney

An appeal of a workers’ compensation decision can result from a variety of situations. Not all appeals are the result of the outright denial of a claim. Sometimes an injured worker has to appeal a decision that does not compensate them for all of the time they missed from their job, does not pay for all of their medical bills, or does not approve a referral for treatment given to them by a medical practitioner.

If a Commissioner’s order has not provided adequate benefits for your injury, consider appealing a workers’ compensation decision in Winston-Salem soon. Call today to set up a consultation with a compassionate attorney to learn more.