Appealing a Kansas Workers' Compensation Denial

Appealing a Kansas Workers' Compensation Denial

If you live in Kansas and are denied workers' compensation benefits, or you don't believe you've been awarded all of the benefits you are entitled to, you have the right to ask for a hearing with the Kansas Division of Workers’ Compensation. You can ask for this hearing at any time up to three years after the accident or within two years after receipt of your last workers’ compensation benefits, whichever is later. (To find out about eligibility and benefits, see our overview of Kansas workers' comp benefits.)

When to Request a Preliminary Hearing

If your employer does not agree that you had a workplace accident, that you reported it properly, that you need medical treatment, that you are temporarily unable to work, or other similar issues, you should request a preliminary hearing.

The first step is to send a Notice of Intent to your employer or its insurance company. The Notice of Intent is a written statement that explains exactly which benefit you are asking for that your employer has denied, and also serves to let your employer know you intend to request a preliminary hearing. For example, if your employer does not agree that you need temporary disability benefits, explain that you do need them and why. If you need medical treatment, explain what medical injury you have and the type of treatment that injury requires.

If, after a week, you and your employer have not resolved the outstanding issues, you can complete an Application for Preliminary Hearing and file it with the Workers’ Compensation Division. Also submit with any evidence you may have and the Notice of Intent that you sent to your employer. Send the documentation to:

Division of Workers' Compensation401 SW Topeka Boulevard, Suite 2Topeka, KS 66603

The Division of Workers' Compensation Applications unit receives and processes applications for hearings. If you have any questions regarding applications, please call (785) 296-4000, Option # 8, for assistance or email wc_app_rsch@dol.ks.gov.

The preliminary hearing will be held in the county where you were injured unless you and your employer agree to a different location.

At the Preliminary Hearing

Preliminary hearings are very informal. Both you and your employer will have the right to present evidence to the Administrative Law Judge, such as medical records, pay stubs, or information about your accident.

If the judge decides you are entitled to medical benefits or temporary disability benefits, you will be able to receive these benefits, but only until a full hearing is held and decided, at which point your benefits may change.

Normally, the judge will make a decision within five days after the preliminary hearing. You and your employer may be allowed to submit new evidence after the hearing date if the judge believes this is reasonable.

When to Request a Full Hearing

If you are unhappy with the results of the preliminary hearing, you have the right to request a full hearing, which will be a full trial of your workers’ compensation claim before an Administrative Law Judge in the Kansas Division of Workers’ Compensation.

To request a full hearing, you will need to complete an Application for Hearing and submit it to the Division at:

Division of Workers' Compensation401 SW Topeka Boulevard, Suite 2Topeka, KS 66603.

When to Hire an Attorney

Filing an appeal can be complex. There are many administrative rules which you may not be familiar with that can make it challenging for you to succeed. If you need to request a full hearing, it's a good idea to consider hiring a workers’ compensation attorney to assist you.

If you decide to represent yourself, you can get help through the Ombudsmen Program. Ombudsmen work for the Department of Labor and are trained in workers’ compensation law. They can give you forms you need to fill out and give you some basic advice on how to proceed with your case. To contact the Ombudsmen program, call (785) 296-4000 or (800) 332-0353, Option #1.

Attending the Pre-Hearing Settlement Conference

Before the actual hearing, or trial, is held, there will be a pre-hearing settlement conference in front of the Administrative Law Judge. This conference will normally be held within ten days before the hearing date.

The purpose of the conference is to see which issues you and your employer can agree upon. If you and your employer cannot agree on how to resolve your claim, then your case will proceed to the full hearing.

What Happens During the Full Hearing

Before hearing your case, the judge will call you and your employer into the judge’s chambers (this is the judge’s office). The judge will explain to you how the hearing will be conducted, such as whether you or your employer will have the right to speak first.

Even though the hearing is similar to a trial because witnesses testify and evidence is submitted, it isn’t as formal as an actual trial. The Administrative Law Judge will allow you and your employer to take turns presenting arguments, evidence, and witnesses. Likewise, you will have the right to ask questions of your employer’s witnesses, and vice versa. The judge can ask questions of you and your witnesses but is not allowed to take sides in the case.

Important: While decisions at preliminary hearings can be made based on medical records, at a hearing only your doctor’s testimony will be accepted. Therefore, you will want to prepared to ask for your doctor to appear at the hearing.

After the Hearing

You can expect the decision of the Administrative Law Judge to be made within 30 days. If for any reason it isn’t, you can ask the Director of the Workers’ Compensation Division, who will normally assign a Special Administrative Law Judge to make a decision on your claim based on the evidence in the record.

Appealing to Workers’ Compensation Board

If you are unhappy with the decision made after the hearing by the Administrative Law Judge, you can appeal to have the Workers’ Compensation Board review the Judge’s decision. However, you must do this very quickly. You must file an Application for Review and Modification within ten days of the date that the Judge’s decision was to go into effect.

You can fax the Application for Review and Modification to the board at (785) 296-8499 or mail it to:

Appeals BoardDivision of Workers' Compensation401 SW Topeka Boulevard, Suite 2Topeka, KS 66603

If you fax your application, you must keep the original application in case anyone asks to see it during the board’s review of your claim. If you have questions, you can call the Appeals Board at (785) 296-4000, Option # 7, or toll-free at (800) 332-0353. You can also email the Appeals Board at wcboard@dol.ks.gov.

You will also be required to submit a written "brief" to explain your arguments. You may wish to hire a worker's comp attorney to help with this and to ensure the filing deadlines are met, as procedural errors can hurt your appeal.

The board will review the case and decide if a hearing will be held so that arguments can be presented. The board can also make a decision on the case without a hearing, or may perhaps send you and your employer to mediation. If the board does hold a hearing, the decision of the board is due within 30 days from the date arguments are presented.

The board can:

  • award or deny you compensation
  • increase or decrease the amount of compensation you will receive, or
  • send issues back to the Administrative Law Judge for another hearing.

Going to the Court of Appeals

If you are unhappy with the decision of the Appeals Board, you have the right to appeal to the Court of Appeals. However, the appeal cannot proceed until the Director’s office certifies the record. Once the board issues its order, the administrative file is returned to the Director of the Division of Workers’ Compensation, and the Director's office is responsible for certifying the record for cases being appealed to the Court of Appeals. Visit the self-help page of the Court of Appeals for more information on how to file an appeal, or consider getting an attorney to assist you.

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