What You Can Do After Your Workers’ Comp Benefits Are Denied

Workers' Compensation

If you were injured in a workplace accident or developed an illness because of your work, chances are you’re entitled to seek workers’ compensation benefits from your employer and their insurance company. In most states, employers are required to have workers’ comp insurance to cover medical expenses, lost wages, and ongoing care costs if an employee is hurt or becomes sick after an accident. These benefits generally also include funeral expenses if an employee dies in an accident.

However, you may find yourself feeling helpless and desperate when you receive a rejection letter in the mail. It’s not uncommon for workers’ compensation claims to be denied, as many employers and insurance companies will look for anything they can use to reject coverage. A denial isn’t the end of the road – you have options.

Understanding Why Your Claim Was Denied

The first step towards securing your benefits after your claim was initially denied is to understand the reasons why. Typically, your rejection letter will explain the reasoning, but our attorney is also available to assess your situation and determine how we can strengthen your claim.

Some common reasons why claims are denied include:

  • You missed a deadline: It’s generally best practice to report your workplace accident and injuries to your employer right away and file a claim as soon as possible. Different states have different filing deadlines; in California, workers have two years from the date of injury to file a workers’ comp claim.
  • Your condition doesn’t meet state guidelines: Not all states cover all injuries. Some states have restrictions on workers’ comp claims when it comes to covering trauma or psychological conditions. Some claims are also denied if your injuries aren’t serious enough for workers’ comp claim requirements.
  • Disputes about whether your injury is work-related: Perhaps the most common reason for claim denials, employers and insurance companies often allege that there isn’t sufficient evidence to show your injuries occurred in a workplace accident. This is where it’s beneficial to hire an attorney who can gather witness statements or medical evidence.

Filing an Appeal

When your claim is denied, you still have the option to file an appeal and secure a hearing before a judge. This process may seem daunting, but our attorney is available to guide you through the process and prepare you. In California, workers must first file an Application for Adjudication of Claim, followed by another application to request a hearing.

In your hearing, you will appear before a judge, who will try to help you reach a settlement. We can investigate your accident and collect evidence that we can present to the judge in order to ensure you receive the full and fair amount of benefits needed to recover.

Knowledgeable on Workers’ Comp Laws in California

Each state has its own workers’ compensation laws and stipulations, which is why it’s essential that you hire a lawyer who is local and well-versed on both personal injury law and the workers’ compensation system. Our attorney has successfully represented the interests of injured workers throughout the state of California and knows that employers are all required to carry workers’ comp insurance.

At Leigh Law Firm, we know that insurance companies and employers often put their own interests before the health and safety of their employees. We can protect you from having your benefits limited or withheld by helping you file your claim or appeal. Whether you’ve been impacted by cancer, arthritis, psychiatric injuries, or some other kind of injury, we have the experience needed to help you navigate your claim and ensure you get the benefits you deserve.

Leigh Law Firm serves Los Angeles and San Diego residents and is available to help you after your claim has been denied. Contact our workers’ compensation attorney today online or by phone at (619) 473-7569 for a free consultation. Our team has the experience needed to help you secure your needed benefits.