It’s called Form 61 — the notice you receive if your North Carolina workers’ compensation claim has been denied. Receiving this form understandably brings on strong emotions for injured workers and their families, and it’s important that you have an experienced workers’ compensation lawyer to help you appeal the decision.
On Form 61, the employer or the insurance carrier must provide a detailed explanation for the denial, and the form must be sent to the North Carolina Industrial Commission, you (the employee), your attorney if you have one, and all known health care providers who have billed the employer or the insurer.
If you receive Form 61, it is crucial that you do not contact the insurance company or otherwise discuss your case any further with the insurance adjuster.
Insurance companies are in the business of providing insurance coverage, but they’re also in the business of denying claims. If you talk to an insurance adjuster after your workers’ comp claim is denied, you could hurt your chances of getting the denial reversed.
The questions the adjuster asks are designed to reduce the value of your claim or deny it altogether, and unfortunately workers with legitimate claims may receive Form 61 after answering the adjuster’s tricky questions.
At The Bollinger Law Firm, we advise our clients not to give the adjuster a recorded statement in any workers’ compensation claim. Instead, our clients rely on us to build a strong claim in order to maximize compensation benefits.
If you receive a notice of denial, you can still appeal to the North Carolina Industrial Commission, but this is best done with the help of an attorney.
After a workers’ comp denial, Form 33 can be used to request a hearing before the NCIC. As with other legal proceedings, it’s important that you don’t try to handle this hearing on your own. Too much is at stake, and the process may require depositions from the doctors who treated you.
For more on the workers’ comp claim process and how The Bollinger Law Firm handles these matters, please see our overview of the workers’ compensation timeline.