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How to Prevent a Workers’ Comp Claim From Being Denied

  • Published: December 14, 2022

California workers’ compensation laws are among the nation’s most worker-friendly laws. Almost every employer in California has the legal responsibility to buy workers’ comp insurance. But, although the laws in California may be commendable, this doesn’t mean it’s always easy to recover workers’ compensation benefits.

If you’ve sustained a job-related injury or you’ve developed an illness due to your work duties, you have the right to file a workers’ compensation benefits claim. But, since insurance companies are profit-driven businesses, they frequently deny claims. Also, employers may also worry about increasing insurance premiums if employees receive workers’ comp benefits. Thus, employers might try to deny claims as well. You don’t need to deal with this. An experienced workers’ compensation lawyer from KCNS Law Group may be able to help.

Steps to Take to Prevent Your Workers’ Compensation Claim in California From Being Denied 

While it’s possible to receive a denial for your workers’ comp claim after submitting it, there are some tips you can follow that may help you prevent this from occurring.

1. Report the Accident Immediately 

Unless you’re injured so severely that you require urgent medical care, following a job-related accident, it’s important that you report the accident promptly to your manager or supervisor. Depending on where you sustained the job-related injury, security cameras may have recorded footage of the accident. If you believe this to be true, tell your supervisor, manager, or property owner to not delete this essential footage and keep a record of you making this formal request.

2. Seek Medical Care 

It’s crucial that you seek medical care on the day you sustain the job-related injury. See a doctor immediately even if you don’t think you sustained any injuries. You may be injured on the job without noticing any signs of injury right away. To make sure you receive treatment as early as possible and to keep an insurance company from arguing later on that there isn’t any proof of your job-related injury, see a doctor right away.

3. Identify Witnesses 

Determine if there were any coworkers who may have been a witness to the accident. If you find witnesses that aren’t coworkers, like customers, obtain their names and contact information. If you require other people to confirm you sustained an injury in the workplace, their testimony can be helpful.

4. Hire a California Workers’ Compensation Lawyer 

Hiring a lawyer is among the best ways of ensuring you don’t have your workers’ comp claim denied. A lawyer who is experienced and specializes in tackling cases like yours may be able to help you collect the documentation and evidence you require to show why you qualify for workers’ comp benefits.

A workers’ compensation lawyer can also help you determine what would make a fair settlement. Chances are good that the insurance provider will attempt to convince you to settle for less compensation than you’re owed if the adjuster isn’t able to find a reason to deny your workers’ comp claim outright. The attorney will take all your compensable losses into account and negotiate with the insurance provider on your behalf for a fair settlement.

Your California workers’ compensation lawyer’s involvement will also provide you with the opportunity to focus strictly on your recovery. Following a job-related injury, you don’t have to add on the extra burden of tackling your claim on your own. An experienced workers’ comp attorney will investigate your job-related accident, attend to all the tasks involved in the process, and submit your claim on your behalf.

What to Do if Your workers’ Comp Claim Is Denied 

After figuring out the reason why your workers’ compensation claim was denied, it’s time to take action to remedy the denial. You’ll need to consult with a skilled workers’ comp lawyer if your injury is being disputed. A lawyer may also be able to help you counter the denial by your employer or the insurance company against your claim.

You’ll also need to collect medical proof, relevant medical expert testimony, and other supporting materials. When appealing the denial, this evidence will be critical.

1. File an Appeal 

After you receive your denial letter for workers’ compensation, you can move forward with filing an appeal against it. This letter will usually include detailed instructions on how to go about filing the appeal. Therefore, it’s essential that you go through it thoroughly.

You’ll then need to present your case to an administrative judge as part of the appeal process. You may also present all relevant proof during the hearing. If after going through the evidence that you present, the judge approves your workers’ comp claim, you will then qualify to start receiving benefits. But, if they don’t find any sufficient evidence that suggests you’re eligible for workers’ comp benefits, you’ll still be able to appeal at higher levels.

2. Hire a California Workers’ Compensation Lawyer 

Hiring a lawyer is an important step when you’ve been denied workers’ compensation benefits. In fact, the most common reason why individuals hire workers’ comp lawyers is that their claims are denied. This can occur if you didn’t file your claim properly or if your employer challenges your injury.

The denial means that you’ll have to present arguments and evidence to support your claim. This is extremely challenging, particularly when you’re up against the insurance company’s lawyers. A workers’ comp lawyer in California with the proper knowledge and expertise can help you navigate the complicated appeals process. The lawyer can also assist you in bringing the relevant evidence together and arguing your case in a more reasonable manner.

Call Our Skilled California Workers’ Compensation Lawyers at KCNS Law Group to Schedule Your Free Consultation 

You shouldn’t have to face the insurance company by yourself. The guidance and support of a highly-skilled workers’ compensation attorney can provide you with peace of mind. Nobody who has sustained a job-related injury should have to jump through hoops to receive the benefits they’re due.

At KCNS Law Group, our California workers’ compensation lawyers are ready to assist you in proving why you’re qualified for workers’ compensation benefits. Our knowledgeable attorneys may even be able to help you qualify for workers’ compensation benefits even if you’ve been denied. Call our law firm today at (818) 937-9255 or fill out our contact form to schedule your free consultation.

KCNS Law Group LLP

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