Navigating the aftermath of a denied workers’ compensation claim can feel overwhelming. In California, when an injury occurs on the job, workers should receive benefits to cover medical costs and lost wages.
However, not all claims sail smoothly through the process. Sometimes, claims get denied, leaving employees unsure of their next steps. It is important to know that a denial is not the end of the road. There are specific actions you can take to contest the decision and seek the benefits you need for recovery.
Review the denial letter carefully
The denial letter you receive should clearly state the reason workers’ comp denied your claim. Read this letter carefully to understand the specifics, as it will determine how you should proceed. Sometimes, the issue may be as simple as missing documentation or a filing error. Identifying and rectifying such issues can help in quickly resolving the problem.
File an appeal promptly
If you believe the denial was unjustified, you can file an appeal. California provides a specific timeline for this—usually, you must appeal within 30 days of receiving the denial. The first step in the appeals process is to file an Application for Adjudication of Claim with the Workers’ Compensation Appeals Board in your local area. This application starts the formal legal process and gets you a case number.
Gather additional evidence
Collecting more evidence can strengthen your appeal. This might include medical records that document your injury, statements from witnesses or additional information from your doctor. Sometimes, obtaining an independent medical examination can provide a second opinion that supports your claim of injury.
Attend the hearings
Once you file for an appeal, you will likely need to attend hearings before a judge at the Workers’ Compensation Appeals Board. During these hearings, you will have the opportunity to present your evidence and explain why your claim should be approved. Preparing thoroughly for this step is important.
A denied claim does not mean you are out of options. By taking these steps, you can actively work towards reversing the denial and obtaining the workers’ compensation benefits you deserve. Being proactive and persistent can significantly enhance your chances of a favorable resolution.
