Attorney Esequiel Solorio is a certified specialist in workers’ compensation law as certified by The State Bar of California Board of Legal Specialization.

Does a denial mean you will never get workers’ comp benefits?

On Behalf of | Oct 31, 2023 | Blog, workers' compensation

According to the Office of Workers’ Compensation Programs, as of October 22, 2023, California had 14,165 claims filed for the year. Not every claim that goes through the system ends with an approval and the claimant receives benefits.

You may wonder what happens when you receive a denial. Does a denial mean you will never get the benefits you rightfully deserve?

Understand the process

It is important to know that a denial of your workers’ compensation claim does not necessarily mean the end of the road. Many claims receive a denial for various reasons, such as incomplete documentation, missed deadlines or insufficient evidence. Remember that the denial is a part of the process, not the final decision.

Review the denial letter

Upon receiving a denial, you should carefully review the letter. It will typically outline the reasons for the denial, allowing you to address any issues that led to the rejection.

Gather additional information

If your claim denial occurred because of insufficient evidence or paperwork, you can gather the necessary documents and medical records to support your case. Make sure you provide a complete and accurate account of your injury, including how it happened and its impact on your work duties.

Consult your supervisor or HR

Sometimes, claim denials are a result of miscommunication or misunderstandings. It is advisable to consult your supervisor or human resources department to clarify any issues and correct any inaccuracies in your claim.

Request a reevaluation

You have the right to request a reevaluation of your claim. This will prompt a review of your case by the insurance company or the relevant workers’ compensation board, and they may reconsider their initial denial.

A denial of your workers’ compensation claim does not mean you will never receive benefits. Consider this just another step in the process. Remember that persistence and proper documentation are key in the pursuit of your rightful benefits.