Learning that your workers’ compensation claim has been denied can be upsetting due to the practical impact on your ability to support yourself and your family. Take comfort in knowing that a denied claim doesn’t always mark the end of the workers’ comp claim process. A qualified California workers’ compensation attorney could help you pursue this type of appeal.
In California, a denied claim can be appealed through a structured process overseen by state law. More specifically, you will need to take your case to the state’s Workers’ Compensation Appeals Board (WCAB).
Having your workers’ comp claim denied when you are struggling and need financial support might leave you feeling hopeless, but the appeals process could give you a second chance to present your case and access the benefits you rightfully deserve.
Before doing so, it’s crucial to understand exactly why your initial claim was denied. This may allow you and your California workers’ compensation attorney to craft an airtight strategy to guide the appeals process to a better outcome than the initial claim.
When California workers’ compensation claims are denied, state officials will send a letter specifying the exact reasons for the denial. This will be extremely useful to you and your attorney as you develop a strategy for seeking an appeal, as you will want to be sure to adequately address every point in the denial letter. However, reviewing this denial letter should only be the beginning when it comes to pre-appeal preparation.
In California, workers’ compensation records are public. This makes it easy to do research on claims similar to your own, but it can also be helpful when you need to obtain a copy of your own case records. After you’ve equipped yourself with all documentation related to your claim and its denial, you should sit down with your attorney and go over every aspect of the claim and denial in detail so that you can begin building an effective appeal strategy.
A workers’ compensation case that goes to appeal can involve many stages, but the process of such a case usually follows these general steps:
A: To appeal your workers’ claim decision, you will file an Application for Adjudication of Claim so that the state Workers’ Compensation Appeals Board (WCAB) can begin a review of your case. Note that this application, much like the initial claim, must be filed within statutory time limits.
A: If your workers’ compensation claim has been denied, and you have not yet enlisted the services of a qualified attorney for legal advice, a good next step is to contact a California workers’ comp attorney to begin the process of developing a winning appeal strategy. You and your lawyer can review the reasons for the denial and attempt to address them in an appeal so that you can get the compensation you need.
A: In the state of California, your employers’ workers’ compensation insurance carrier has 90 days to accept or deny the claim. Extensions to this timeline may be granted in cases that call for extensive investigation. If your claim is denied, you could still appeal the decision to potentially have it reversed.
A: While claim denials themselves are not necessarily a matter of OSHA record, the incident that caused the injury in question might still require OSHA reporting if it meets their criteria. The concept of OSHA reporting is separate from the status of your workers’ compensation claim, although it stands to reason that incidents meeting the OSHA definition of a workplace injury will often be eligible for workers’ compensation benefits.
If your workers’ compensation claim has been denied, but you’re unable to work, and in dire need of financial support, we can help. The talented workers’ compensation team at Canlas Law Group is ready to help you implement an airtight strategy for seeking an appeal and reversal. Contact us today to begin the appeal process with a no-pressure consultation.