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

Navigating denied workers’ comp claims in California

On Behalf of | May 13, 2024 | workers' compensation

Understanding the workers’ compensation process can be crucial when you’re dealing with an injury sustained at work.

However, challenges can arise if your claim is denied, leaving you to navigate the complexities of the system to secure your benefits.

Understanding workers’ compensation claims

Workers’ compensation is a form of insurance that offers financial assistance if you suffer an injury at your workplace. It eliminates the need to pursue legal action against your employer by directly providing funds for medical care and lost earnings due to work-related injuries.

Common reasons for claim denials

Claims often face denials due to discrepancies over where the injury occurred or if there is insufficient evidence that the injury is work-related. Delays in reporting the injury can also lead to a denial, as timely communication is crucial for claim acceptance.

Steps to take after a claim denial

Upon receiving a worker’s comp denial, carefully review the explanation provided. The denial notice will guide you on how to appeal the decision. Promptly completing the necessary forms to initiate an appeal is essential. Assemble all relevant medical documentation, secure witness statements, and gather any evidence related to your job duties that support your claim. These steps are vital in strengthening your appeal at the hearing.

Safeguarding against unfair treatment in the workplace

Under California law, employers are prohibited from retaliating against employees for exercising their rights. This includes workers who file workers’ compensation claims. If you experience reduced hours, pay cuts, or other punitive measures after filing a claim, you can seek recourse. This typically begins by contacting the California Labor Commissioner’s Office.

If workers’ compensation denied your application, it is important to understand your options. That way, you can fight for your rights and get the compensation you deserve.