What Are the Common Reasons Workers’ Compensation Claims Are Denied?
If you were hurt on the job, you’ll have to consider how you’ll pay for medical expenses, treatments, and potentially surgery. Your injuries may also require a lengthy recovery period before you can return to work, resulting in lost wages. Under California’s workers’ compensation system, most, if not all, of these losses are recoverable by filing a workers’ compensation claim. Unfortunately, some insurance companies and employers will quickly dispute injured workers’ compensation claims or try not to provide the full benefits that injured employees, and their families deserve.
If you’ve suffered a workplace injury in California, get in touch with KCNS Law Group, LLP’s knowledgeable workers’ compensation attorneys to learn how we can help you achieve maximum workers’ comp benefits you deserve.
Eight Reasons Why Your Workers’ Compensation Claim May Be Denied in California
Workers’ compensation insurance in California provides benefits for any injuries or illnesses you may experience during work-related activities. It’s a requirement for all employers in California to provide workers’ comp benefits, with few exceptions permitting any dispute or denial of workers’ compensation claims. However, denial of benefits do occur in some cases.
Below are some of the most common reasons why your employer or workers’ compensation insurer may deny or dispute your claim in California:
- Employment is at issue: The injured worker must be an employee as opposed to an independent contractor to be eligible for workers’ comp benefits
- The injury did not arise out of employment or during employment: The employee must have been injured while performing their job duties
- The Statute of Limitations barred the workers’ comp case: The case was not filed in a timely fashion, usually within 30 days from the date the injury occurred
- Injuries were not work-related: The injuries must have been at least partially caused or aggravated by work injuries
- Post-termination defense: If an employee filed the workers’ comp claim after being terminated by their employer, then there is a presumption that they merely filed the claim in retaliation for the termination
- Lack of medical records: If there is no medical evidence to substantiate the claim, insurers or employers may dispute or deny benefits
- The injury was caused by horseplay or intoxication: Injuries must occur while performing work-related activities
- The injured worker was the initial aggressor in an altercation: Insurers or employers may deny benefits to workers whose injures were caused after aggressively confronting other employees
How Can I Assist My Workers’ Comp Attorney in Getting the Most Favorable Outcome in My Case?
The most important thing a client can do is keep detailed records and copies of all relevant:
- Medical records in their possession,
When filing a workers’ compensation claim, you should also include documents you may have signed or received in the mail. If you’ve suffered an on-the-job injury, be sure to keep track of out-of-pocket expenses relating to your work injury and a timeline of important dantes—all of which would be very helpful to your attorney.
Do I Need an Attorney to Pursue a Workers’ Compensation Case?
You do not necessarily need a workers’ compensation attorney, and an injured worker can always seek the services of an Information and Assistance Officer at California’s Division of Workers’ Compensation. However, it is highly recommended that injured workers hire an attorney to help them maximize the workers’ comp benefits they are entitled to receive. The workers’ compensation system is becoming increasingly difficult to practice given all the major legal reforms and constant changes in the laws and procedures that govern it.
For that reason and more, having a qualified attorney represent you and help you navigate the workers’ comp system would be a tremendous advantage in maximizing your benefits.
Why Do I Need an Experienced Workers’ Compensation Attorney over a Personal Injury Attorney to Handle My Case?
Workers’ compensation is an administrative area of law with its own unique set of laws and procedures highly specialized and different from other areas of the law. Workers’ compensation cases do not fall under the general civil rules and procedures that govern most other areas of law. Therefore, if you’ve been injured at work, we highly encourage you to retain the services of an experienced workers’ comp attorney to represent you in your case.
What sets KCNS Law Group apart is that our firm concentrates on California workers’ compensation cases. Our firm has decades of collective experience practicing both sides of workers’ compensation law. All of our attorneys previously served as work comp defense attorneys representing employers, government entities, and workers’ compensation insurance carriers. We believe that having experience as both former defense attorneys and now exclusively applicant attorneys gives us a tremendous edge over others.
Talk to a Skilled California Workers’ Comp Lawyer in Glendale for Free Today
If you’ve been hurt on the job, you deserve the maximum workers’ compensation benefits that you are entitled under California law. At KCNS Law Group, our accomplished team of workers’ compensation lawyers fight for you and your family to obtain just benefits for our clients in Glendale and across Southern California.
For more information on why your workers’ compensation claim may be denied, talk to one of our legal professionals and schedule your free initial consultation. Get the information and legal answers you need to support you and your family by calling (818) 937-9255 or completing our contact form today.
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