What to Do If My Workers’ Compensation Claim Is Denied

If you have filed a workers’ compensation claim, only to have it denied, do not fall into the trap of assuming that you are out of options. There actually are several steps you can take. Keep reading to learn more about this difficult situation, and then contact The Law Offices of Larry H. Parker at 866-536-5788 to learn how an attorney might be able to help you.

Why Was Your Workers’ Compensation Claim Denied?

The first step is to determine why your claim was denied. Your denial letter should explain in detail what the reason was. It could be that you were not eligible. For example, if you were taking part in “horseplay” at work and were injured, then you might not be eligible for workers’ compensation. However, if you believe that the denial is an error, then you can appeal it.

Common Reasons That Workers’ Compensation Claims Are Denied

Before we get to the appeal process, let us go over some of the most common reasons that a workers’ compensation claim is denied:

  • The Injury was not reported in writing within the required timeframe
  • The claim was not filed in time based on California law
  • The employer disputes the claim
  • You did not receive medical care
  • A lack of evidence that the injury occurred at work

Note that this is only a partial list – there are many other reasons that your claim could have been denied.

How to Appeal a Denial of Workers’ Compensation

The denial letter will include information, including the deadline by which you can file for your appeal. You could also talk to your employer or their insurance company to determine if it was the result of an error or simple misunderstanding that can easily be straightened out.

If you do need to appeal, know in advance that this can be a complex legal proceeding. We suggest that you work with an experienced workers’ compensation attorney. The appeals process often requires a hearing before an administrative law judge, and there might be several levels of appeal to go through.

Your Case Might Require a Personal Injury Claim

In some cases, it might be that you need to sue your employer directly. There are pros and cons to this. First, if you file a personal injury claim, you can sue for all damages, while a workers’ compensation claim does not allow you to collect damages for pain and suffering and does not cover 100% of your lost wages.

The disadvantage is that you do not have to prove your employer was at fault for a workers’ compensation case while you will need to do so for a personal injury case. If you are not sure what avenue to take, or you need help appealing your workers’ compensation denial, contact The Law Offices of Larry H. Parker at 866-536-5788 today.

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