A workplace injury can leave anyone feeling anxious and uncertain about what comes next. Between medical treatments, missed paychecks, and dealing with the insurance company, getting a denial letter on your workers’ compensation claim can feel discouraging. The good news is that a denial doesn’t mean your case is over. In Kentucky, injured workers have the legal right to appeal that decision and continue pursuing the benefits they deserve.
At Brandon J. Broderick, Attorney at Law, our attorneys routinely assist clients in appealing denied workers’ comp claims in Kentucky. We see this situation often—people with legitimate injuries being denied for technical reasons, missing information, or misunderstandings about the cause of their injury. This article explains why claims are sometimes denied, how the Kentucky appeal process works, and what steps can help you strengthen your case.
Why Workers’ Comp Claims Are Denied in Kentucky
Workers are sometimes surprised to learn how common denials are. Even when an injury clearly happened on the job, insurance companies may reject claims to limit costs or delay payment. We’ve seen it happen for several reasons. Sometimes the injured employee waited too long to notify their employer. Kentucky law doesn’t set a specific deadline for reporting, but it does require workers to report injuries “as soon as practicable.” The longer the delay, the easier it is for insurers to question whether the injury occurred at work.
Another common issue is insufficient medical documentation. If a doctor doesn’t clearly connect your injury to your work duties, an insurer may argue there’s no proof that your job caused it. Employers also frequently claim that the injury was pre-existing or unrelated to job activities. In other cases, the denial is due to a simple paperwork error—forms filled out incorrectly or missing signatures that slow down the process.
Even when a claim is denied, it doesn’t mean your injury isn’t valid. In many cases, the denial can be reversed with additional evidence or a properly prepared appeal.
How Kentucky Workers’ Compensation Law Protects Injured Employees
Kentucky’s workers’ compensation system, established under KRS Chapter 342, provides medical, wage, and disability benefits to most employees injured at work. These laws ensure that injured workers receive fair treatment, even if their initial claim is denied. If that happens, you can request a full review through the Kentucky Department of Workers’ Claims (DWC).
An Administrative Law Judge (ALJ) reviews your case independently. The judge evaluates the medical records, testimony, and evidence from both sides before issuing a written decision. If either party disagrees, the ruling can be appealed to the Kentucky Workers’ Compensation Board, which checks for legal or procedural errors. Additional appeals can go to the Kentucky Court of Appeals or, in some cases, the Kentucky Supreme Court, though those courts mainly review whether the law was applied correctly.
It’s also worth knowing the timeline for filing claims. Under KRS 342.185, most employees have two years from the date of injury—or from the last voluntary payment of benefits—to file a workers’ compensation claim. Missing that window can make it difficult or impossible to pursue benefits later.
The Workers’ Comp Appeal Process in Kentucky
When a claim is denied, the appeals process begins by filing Form 101 – Application for Resolution of Claim. This form officially opens your case before the DWC. It must include information about your employment, how the injury happened, your treatment, and supporting documents like medical records or witness statements.
After filing, the case is assigned to an Administrative Law Judge. The first step is typically a Benefit Review Conference, where both sides meet to identify the disputed issues and discuss possible resolution. Sometimes, these conferences lead to settlement agreements without the need for a formal hearing.
If no agreement is reached, the case proceeds to a hearing. Each side can present evidence, question witnesses, and provide expert medical opinions. The ALJ then issues a decision based on the evidence and Kentucky law. If the decision is unfavorable, you have 30 days to appeal to the Kentucky Workers’ Compensation Board. The Board reviews the case record but does not take new evidence.
A worker who still disagrees with the outcome can appeal further to the Kentucky Court of Appeals and, in limited circumstances, the Kentucky Supreme Court. These higher courts review legal arguments rather than re-evaluating the facts of the injury.
Example from a Kentucky Worker
Our firm once represented a warehouse employee from Lexington who injured his shoulder after slipping on a wet loading dock. His employer’s insurer denied his claim, arguing the pain came from a prior sports injury. With help from our legal team, the worker obtained a specialist’s opinion linking the injury directly to the fall at work. On appeal, the Administrative Law Judge ruled in his favor, granting full medical coverage and back pay. His case illustrates how persistence and well-prepared evidence can turn a denial into a successful claim.
Strengthening Your Appeal
When appealing a denied claim, details matter. The strongest cases are built on clear medical evidence, consistent statements, and complete records. Here are two key strategies our attorneys often recommend:
- Gather compelling evidence. This includes updated medical opinions that clearly explain how your injury occurred at work, statements from witnesses who saw the incident, and proof of how your injury has affected your ability to work or perform daily tasks.
- Work with an experienced Kentucky workers’ comp attorney. The appeal process involves strict filing requirements, legal rules, and deadlines. A knowledgeable attorney can prepare your claim, present evidence effectively, and protect your rights through every stage of the process.
Common Mistakes to Avoid
Many appeals fail because of simple, avoidable errors. Missing deadlines, skipping medical appointments, or giving inconsistent statements can damage credibility. Others try to handle the process alone and overlook key documents or evidence. Consistency, organization, and timely responses make a significant difference in how a case is viewed by the judge.
Our firm regularly helps clients avoid these pitfalls. We ensure forms are filed properly, medical evidence is clear, and clients are fully prepared for hearings. Having a legal advocate who understands Kentucky’s workers’ compensation procedures can prevent small missteps from derailing your case.
Call Brandon J. Broderick For Legal Help
If your Kentucky workers’ compensation claim was denied, you still have options. The law gives you the right to appeal, present new evidence, and seek a fair review of your case.
The attorneys at Brandon J. Broderick, Attorney at Law have extensive experience representing injured workers throughout Kentucky. We understand how the appeals process works and what it takes to win. Our legal team can evaluate your case, explain your rights, and guide you every step of the way.
Contact us today for a free consultation.