If your workers' comp claim has been denied, or you have a dispute with the insurance company about your benefits, you can challenge the decision with the Mississippi Workers' Compensation Commission. (For an overview of eligibility and benefits, see our article on filing a workers' comp claim in Mississippi).
To start your appeal, you must file a Petition to Controvert (Form B-5,11) with the Mississippi Workers' Compensation Commission. You should include the original and three copies. Strict time limits apply to filing a petition: You must file within two years of the date of your injury.
Once the Commission receives your petition, your case will be assigned to a workers' compensation judge. The insurance company will be notified of your petition and asked to submit a written response.
Most workers' compensation cases in Mississippi are settled through informal negotiations with the insurance company. However, if you are not able to resolve the dispute, you will have an administrative hearing before a workers' comp judge.
Before the hearing takes place, both sides will participate in a legal process called "discovery." Discovery is an opportunity for you and the insurance company to exchange information, question witnesses, and otherwise gather evidence in support of your case. At the end of this process, which takes at least a few months to complete, your case will be scheduled for a hearing. Both you and the insurance company will need to submit a prehearing statement, which outlines the issues in dispute and the evidence to be presented at the hearing.
At the hearing, both sides will have an opportunity to submit documents, present testimony from witnesses, and make legal arguments. The judge will review the evidence and mail a written decision after the hearing.
If you are not happy with the judge's decision, you can appeal to the Full Commission. To do so, you must file a petition for review within 20 days of the judge's order. The Full Commission does not usually hold another hearing, but may decide to do so upon request. And, both parties can submit written briefs with legal arguments in support of their positions. The Full Commission will mail a written decision to the parties.
If you are not satisfied with the Full Commission's decision, you can appeal through the state court system. You must file an appeal with the Workers' Compensation Commission within 30 days. The Commission will then send the record of your case to the Mississippi Supreme Court for review.
While it's not a requirement, most workers with contested workers' compensation cases hire lawyers to represent them in the appeals process. The appeals process requires detailed knowledge of workers' compensation law and procedural rules, especially when it comes to presenting your case at a workers' compensation hearing. Having a lawyer on your side can greatly increase your odds of success.
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