Appeal a California Workers’ Comp Denial

Need to Appeal a California Workers’ Comp Denial?

Our Gilroy Lawyers Can Help You Appeal a Your Case

When you are involved in an accident at your workplace that leaves you injured, then you may be entitled to receive compensation and protection from your employer. Typically, you would file a workers’ compensation claim to seek recovery for the cost of your medical bills and a portion of your lost wages. However, this process can become complicated and in some instances, your claim will be denied. This can be a frustrating point in your road to recovery, but the road does not necessarily end here.

If your workers’ compensation claim has been denied, ask a Gilroy workers’ comp attorney to review your case and the reasons given for the denial. A skilled attorney will look for ways to potentially appeal the denial and can discuss what other legal options you may have regarding injury compensation. Don’t stop the fight for your rights to benefits just because your claim has been denied. Get competent legal advice from knowledgeable workers’ comp denial attorneys at Cramer & Martinez, LLP who has extensive experience in filing and appealing denied claims.

Why Was My Workers’ Comp Claim Denied?

If your claim for workers’ comp was denied, you need to first go through the process of determining the reason why. This should be explained in the denial letter, but can sometimes be vague as to why exactly your renal was processed. You could be denied for simply not meeting the eligibility requirements. These requirements can include such behaviors as getting injured while engaging in “horseplay” or while away from work. Such actions would not be eligible for an appeal. But if you believe the denial was reached in error, you may have an opportunity to appeal. Other common reasons for a denial of workers’ comp benefits include the following:

  • Injury was not reported in time: State laws determine how soon you must report an injury to your supervisor, typically within a few days to begin the process of compensating for losses.
  • Claim was not filed in time: State laws determine strict deadlines for filing an initial claim, typically 30 to 90 days. These laws vary between states, counties and even professions, so it is important to stay informed on your deadlines.
  • Employer disputes claim: Your employer may claim the accident happened outside of work, was the result of unapproved actions, or some other disqualifying reason
  • Injury is not compensable: Claims for stress-related injuries or other unquantifiable injuries are very difficult to prove in many states. California is one of the few states that covers stress-related injuries, but the requirements are still fairly strict.
  • No medical treatment documented: In most cases, you must obtain medical treatment in order to receive workers’ comp benefits. If you avoid necessary treatment for any reason, you could jeopardize your ability to receive benefits.
  • Insufficient evidence that injury is work related: It’s not always clear whether an injury happened at work or on your personal time. Additional medical exams and supplemental evidence may help your case.

There are plenty of other reasons why your workers’ comp claim may have been denied. This does not mean that you are unable to process an appeal. Often times, additional documentation is all you need to have your claim approved. If you want to pursue an appeal, timing is everything.

When Should I Appeal My Workers’ Comp Denial?

Finding out your claim was denied does not mean the legal process has ended. If you believe that you did not receive the correct verdict, call our office immediately after you receive your physical denial to learn what your legal options are. We have extensive experience handling complicated workers’ compensation claims and have successfully handled denied claim cases. We can appeal either your employer or your insurance company’s decision and work to expedite the appeals process. It is crucial that you contact a workers comp denial attorney as soon as possible. If you wait to reach out, you could risk your limited opportunity to recover financial compensation.

Were You Hurt on the Job? Gilroy Workers’ Comp Attorneys Can Help

If you have been injured in a workplace accident, then you may be entitled to receive compensation to recover from your injuries. However, you do not need to be fearful for your future, even in the face of denial. Using all of our resources, we will investigate the details of your case and fight for your recovery as many times necessary. Our attorneys for workers’ compensation will guide you through the claims process at every step. If you have suffered from a work place accident, then call us today at (408) 848-1113 or contact us through our online form. In a free initial consultation, we can let you know if we can help. A California workers’ comp attorney is ready to discuss your rights, responsibilities and the recovery you deserve.

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