What to Do If Your Workers' Compensation Claim Is Denied

 Posted on August 04, 2022 in Workers' Compensation

As if getting hurt at work is not bad enough, finding out that your rightful claim for Workers’ Compensation has been denied can make your life that much harder. Claims can be denied for any number of reasons, reasonable or otherwise. It could be that you are having a hard time proving that a repetitive stress injury was caused by your work, or that someone is under the false impression that you are exaggerating the extent of your injury.

Whatever reason you were given for having your claim denied, there may be steps an attorney can take to appeal the board’s decision and hopefully get you the compensation you need to get better. Cramer + Martinez knows how a denied claim can affect the financial health of your whole family, and we will fight to make it right. 

Appealing a Denied Workers’ Compensation Claim in California

If your initial claim was denied, do not panic. You have the right to appeal the decision, and it is best that you do so with assistance from a trained attorney. The first order of business will be to figure out why your claim was denied. Reasons your claim might have been denied include: 

• Unclear causation - To receive Workers’ Compensation, you must be able to show that your injury happened at work. If you fell off the scaffolding on a construction site or something like that, this is very easy to show. However, if you are suffering from a repetitive stress injury like back pain from stocking shelves or carpal tunnel syndrome from typing on a non-ergonomic keyboard, it may be more difficult to show that your injury happened at work. Your lawyer can help you collect evidence to prove that yours is a work injury. 
• Not seeking care - Workers’ Compensation recipients are expected to follow through with the plan of care their doctor has established. Missing follow-up appointments or skipping physical therapy, as well as engaging in activities your doctor told you to avoid could all become grounds for a denied claim. Getting back into compliance with your treatment plan is important. 
• Questioned injury - You know your body better than anyone, and if you are in pain, then you are in pain. It can be immensely frustrating to be told that your injury does not need treatment or to have someone who does not understand what you are feeling tell you that you should be able to work despite the injury. Getting a second opinion can be immensely helpful if the first doctor brushed you off. 

Once your lawyer understands the reason for the denial, he or she can help you establish a plan for appealing. 

Contact a Santa Clara County Workers’ Compensation Attorney

Cramer + Martinez is committed to helping injured workers get the compensation they need. If you have been injured at work and had your claim denied, our skilled Morgan Hill Workers’ Compensation lawyers can fight for you. Call 408-848-1113 to arrange a free consultation. 

Source:

https://www.dir.ca.gov/wcab/wcab.htm