Can I File an Appeal if My California Workers’ Compensation Claim Was Denied?

 Posted on December 24,2020 in The Workers' Compensation Process in Calfornia

Workers’ compensation benefits can help an injured worker pay for medical expenses and other costs related to a work injury. However, filing a workers’ compensation claim and successfully recovering benefits is often more difficult than many workers expect. If your workers’ compensation claim was denied, you may be worried about how you will pay your bills and receive the medical care you need. Fortunately, you may be able to appeal a workers’ compensation denial.

Determining the Reason for Workers’ Compensation Denial

If you or your loved one was denied workers’ compensation after a work accident, you may be confused and unsure as to why the claim was denied. Workers’ compensation claims are denied for many reasons. In some cases, the insurer or employer may simply not have received enough information about the injury to make a proper assessment about workers’ compensation benefits. Mistakes made on the part of the injured worker or the insurer/employer may also lead to delays or denials. Workers’ compensation benefits are contingent on the injured worker meeting specific filing requirements and deadlines. The insurer or employer may also deny you if the way you were injured makes you ineligible for benefits. Injuries that occur while a worker is under the influence of drugs or alcohol, self-inflicted injuries, injuries caused by a preexisting condition, or injuries that are unrelated to work are not typically covered by workers’ compensation. Employers or insurance companies sometimes wrongfully deny workers’ compensation claims.

Appealing the Decision

If you were denied coverage under California workers’ compensation laws, you have the option of appealing the decision. To do so, you must file a form called a “Declaration of Readiness to Proceed.” You may then attend a hearing with the Worker’ Compensation Appeals Board (WCAB) and argue your case in front of a judge. A workers compensation lawyer can help you fight for the benefits you need. Your lawyer will help you use medical records and other evidence to demonstrate your eligibility for workers’ compensation and represent you during the hearing. If a settlement cannot be achieved, your attorney can also represent you during trial.

Contact a Morgan Hill Workers’ Compensation Lawyer

Workers’ compensation benefits can help an injured worker receive financial compensation for medical expenses, lost income from missed work, and more. However, successfully recovering compensation through workers’ compensation is often a complicated endeavor. For help filing a workers’ compensation claim or appealing a workers’ compensation denial, contact a Gilroy workers’ compensation attorney from Cramer & Martinez, LLP. Call us at 408-848-1113 for a free confidential consultation.

Source:

https://www.dir.ca.gov/dwc/WCFaqIW.html