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Challenging the denial of a California workers’ comp claim

| Jun 26, 2020 | Workers' Compensation

Your job is supposed to be a source of income, not financial liability. Unfortunately, if you get hurt on the job, you may find yourself unable to earn anything and also facing a growing stack of medical bills.   Workers who get hurt on the job can experience near-immediate financial hardship because of their injuries, especially if they are so bad that they can’t return to work.

If you understand your rights, you may have already applied for workers’ compensation benefits and sought medical care, assuming you would receive the benefits you requested. Unfortunately, some people with significant work injuries can still wind up with a denied initial workers’ compensation claim.

If you receive a denial, you have the option of challenging it and requesting a review that might connect you with the benefits you need.

You can formally request a review and a hearing

Once someone rejects your application, your only option to protest that determination will involve attending a hearing. In order to request a review of your claim, your condition and your denial, you will need to file an Application for Adjudication of Claim with the Division of Workers’ Compensation.

Once the state receives and processes the paperwork you filed, they will send you a letter with a case number. At that point, you will have the option of filing a Declaration of Readiness to Proceed, which will allow you to request a formal hearing. You should wait until you have all the necessary documentation and help in order to successfully appeal your denied claim.

Planning for a workers’ compensation hearing

At the hearing, you will have to show documentation that affirms that you have an injury that keeps you from working and has created medical expenses. You will also have to show that you suffered that injury as a result of your job.

A copy of paperwork submitted to your employer, statements from witnesses who saw the accident happen and even security camera footage can help you bolster your claim for workers’ compensation and convince the administrative law judge hearing your claim that the denial you initially received did not accurately reflect the situation. Medical bills and recommendations for future treatment can also help you build your case.

The more evidence you have and the more timely your response to a denial, the better your chances of successfully appealing that decision.