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My Workers' Comp Claim Was Denied. Is My Case Over?

Workers' Compensation claim form on laptop screenIn 2015, more than 20,000 workers’ comp claims were rejected, but there were about 2.9 million nonfatal workplace injuries and illnesses that could have been covered by insurance. Companies have many reasons to reject claims, such as:

  • Late filing
  • Insufficient medical data
  • Injury sustained off the clock
  • Employer dispute
  • Damage doesn’t fit long-term injury definition
  • Errors in paperwork

Sometimes their concerns are legitimate, but an insurance company makes money by collecting monthly premiums, not paying claims. So, while you may be surprised your workers’ comp claim was denied, don’t be disheartened. Many compensable situations are rejected. You can file what is called an appeal to the insurance company.

A workers’ comp appeal needs to be filed with a local Division of Workers’ Compensation (DWC) office. You’ll need to send in at least two different forms, after which your case will be looked at by at one or more judges. This process works best with a lawyer on your side. Not only would an excellent attorney know which paperwork needs to be filed, but they would know where to file and before what date. Your lawyer can also help you if a judge denies your appeal by assisting you in filing a Petition for Reconsideration.

While filing a claim with an insurance company may be complicated, appealing its decision is even more so. Keep your letter of denial on file to help you with your case. The letter will often tell you the general reason your claim was rejected, which your lawyer can then use to defend your case in court.

Make sure you contact a Woodland Hills attorney who is familiar with California workers’ compensation laws. Appeal deadlines are very strict, so the sooner you call a lawyer about your case the better your chances will be. Let us help you with this process. We have decades of experience in this legal field. If you don’t get any benefits, you do not have to pay us any fees. Call us at (818) 403 -3737 or fill out our online form with your case details for a free consultation. Let us get you the compensation you deserve.