Navigating Workers’ Compensation Appeals

Officer John Abel
Secretary

Weekly, I hear from LVPPA members about how bad CCMSI is when it comes to having claims involving job-related injuries approved for treatment. There are some horror stories, such as CCMSI claiming that running in the Academy is not an official job-related duty, so many Academy recruits have had injury claims denied that occurred while they were conducting Academy PT activities. CCMSI can be difficult to navigate, and there are occurrences when hiring a law firm to deal with them is appropriate, but it is not always the first step that an officer should take after they have a denied claim from CCMSI.

The first thing CCMSI does, whether they approve a claim or not, is send the affected employee a letter to their home outlining why or why not their claim is approved. If an employee has a denied claim, the letter outlines how to appeal the decision. Every employee who has a denied claim must appeal the decision or risk having thousands of dollars in medical bills go unpaid because the Health Trust will also deny the claim and not pay any bills until the workers’ compensation appeals process is exhausted.

I would rather walk you through the process than see your paycheck garnished by a debt collector (yes, it has happened) for medical debt that you owe.

There are two Department-related pieces of mail that should never be ignored: letters from CCMSI and letters from the Health Trust. Both pieces should be treated with urgency and read in their entirety. Also, know that as soon as you retain a workers’ compensation attorney, CCMSI becomes less inclined to speak with you about your claim. Even if you get the letter and have no idea what the next step is and have no idea who to call, you can call the PPA office and ask to speak to me. I would rather walk you through the process than see your paycheck garnished by a debt collector (yes, it has happened) for medical debt that you owe. I know the process should not be this painful, but until LVMPD decides that they have had enough of CCMSI shenanigans, the process is the process.

A few more tips when it comes to getting your workplace injury approved include making sure you are very descriptive on your occupational injury form and making sure you list all witnesses and their contact information. Also, make sure the C4 form and the occupational injury form do not in any way contradict each other. Sometimes, it’s the little mistakes that get a workers’ compensation claim denied, so being as descriptive as possible is imperative.

To reiterate, do not ignore mail from CCMSI or the Trust. Please be aware of appeal timelines so that you do not lose your appeal rights. Be aware that immediately hiring an attorney after a denied workers’ compensation claim may significantly slow down the process. Lastly, call the PPA office if you P# 8731 have any questions regarding CCMSI issues, appeal questions or Health Trust questions. We are available 24 hours a day, seven days a week for your concerns. As always, I can be reached at jabel@lvppa.com or at (702) 468-0766.