3 common reasons California workers’ comp claims are denied

On Behalf of | Aug 21, 2017 | Workers' Compensation

In California, if you are injured on the job, you generally have a right to workers’ compensation. There are relatively few types of jobs that don’t require employers to carry workers’ comp insurance, so chances are that you are eligible for benefits if you are injured at work.

Still, workers’ comp benefits can be denied for various reasons, and it’s important to be aware of those reasons so you can get the benefits you need and deserve. Here are three common issues to be aware of.

1. Not Getting Medical Treatment

After an injury at work, it is important to get medical treatment. Getting medical care is the right thing to do for your health, and you will need medical records for your workers’ compensation claim. Insufficient medical evidence is a common reason for the denial of workers’ comp benefits.

Also, if you miss your medical appointments and do not reschedule them, the insurance company will likely view this as evidence that you no longer need care because your injuries no longer affect your ability to work. In other words, it’s important to go to your medical appointments so there is clear documentation of your injury.

2. Waiting Too Long to Report the Injury

After a work injury, you should inform your employer that you were hurt on the job. Depending on the circumstances, it may not be clear at first that your injury is work-related, but once you believe it is, you should tell your employer. For example, repetitive-motion injuries develop over time, and it may not seem obvious at first that they are work-related when they really are.

Generally, in California, you have 30 days to give your employer written notice of the injury.

3. Employer Disputes the Claim

Your employer may try to deny your workers’ comp claim for a number of reasons. The employer may say that the injury occurred outside of work, or maybe the employer claims that you were at work but not doing work-related activities when the injury happened.

If this is your situation, talk to a workers’ compensation attorney about your options. Really, it is best to have a workers’ comp lawyer handle your claim from start to finish to avoid mistakes and present the strongest possible claim.

If your benefits have already been denied, you still have a right to appeal, and many benefits are granted in the appeals process. Again, talk to an experienced workers’ compensation attorney about appealing a denied claim.

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