Frequently Asked Questions About Workers’ Comp Claim Denials
With over a decade of experience, the lawyers at Workers' Compensation Lawyer, Inc., have heard and answered a lot of questions regarding workers’ compensation claim denials in California. Here are a few of the most common.
Why Was My Workers’ Compensation Claim Denied?
There are processes that must be followed to receive workers’ compensation benefits, and doing something incorrectly or too late can jeopardize the success of a claim. Claims can also be denied if an employer and/or their workers’ compensation insurance company does not believe the employee’s injuries are work related or thinks that they are exaggerating the severity of their injuries. Although these reasons can be valid concerns, there are some cases in which employers and their workers’ compensation insurance companies deny claims because they do not want to provide benefits to an injured employee.
A workers’ compensation claim may be denied for the following reasons (or, an employer and their workers’ compensation insurance company may give these reasons for denying a claim):
- Claim was filed too late
- Claim was not filed correctly
- Injuries were not work-related
- Injury severity was exaggerated
- Dishonesty about required treatment
- Injuries occurred when the employee was under the influence of alcohol or drugs
- Injuries were caused by gross misconduct by employee
For more information on claim denials, see the Reasons Why Your California Workers’ Compensation Claim May Have Been Denied page on our website.
What Should I Do If My Workers’ Compensation Claim Was Denied?
If your workers’ compensation claim has been denied, you have a right to file an appeal. To prepare for this, you should first hire an attorney – the legal team at Workers' Compensation Lawyer, Inc., can help you.
You should collect all materials you have related to your claim and its denial. You should retain copies of your claim forms and any other official documents you have received from your employer. Your medical records related to your work injury will be valuable as well. You should also keep any communication you had with your employer about your claim. This may include emails, text messages, and other types of correspondence. If you were given a reason why your claim was denied, you should save anything related
to the reason you were given and anything that contradicts that reason. All of this information can be helpful in building a case to appeal your claim.
What Is Involved In The Workers’ Compensation Appeals Process?
Workers’ compensation appeal hearings are similar to a trial. A judge will preside over your case and will hear your arguments as well as those of your employer and their workers’ compensation insurance company. The judge will then make a decision about whether or not you can receive benefits. It is possible that your case may move forward to an actual trial if the judge feels it is necessary.
More Questions? We Can Help.
If you were injured at work and were denied workers’ compensation coverage, Workers' Compensation Lawyer, Inc., can help you recover the benefits you deserve. It is possible to appeal a denied workers’ compensation claim in order to receive benefits. We will represent your rights and take on your employer and their insurance company so you can get the care you need.