Denied Claims

Denied Workers’ Compensation Claim Attorneys in Chula Vista

Assisting Clients Who Have Denied Workers' Comp Claims in California

As the victim of an injury at work, you could be entitled to workers’ compensation benefits. If your claim was recently denied, you might be wondering what’s next on your path to recovery. While a claim denial can feel like a major blow to your ability to get back to work, you still have options for recovery.

In fact, you can still have success in obtaining benefits by appealing your claim. To do this, you should speak with an attorney today.

At The Sexton Law Firm, we have more than 15 years of experience fighting for the rights of injured workers. We understand why claims are denied and how to work within the system to get you the benefits you need.

Call the Sexton Law Firm today at (619) 202-8976 or contact us online to schedule a consultation with our denied workers' comp claim lawyer in Chula Vista.

Who is Eligible for Workers' Comp?

In California, workers’ compensation benefits employees injured on the job, regardless of fault. Most employees are eligible for workers' comp if their injury or illness is work-related. This includes physical injuries, repetitive stress injuries, and even mental health conditions that develop due to workplace conditions. Whether you’re a full-time employee, part-time worker, or contractor, you may qualify for workers’ compensation benefits.

However, not all claims are approved. Insurance companies or employers may dispute a claim for several reasons, ranging from missing deadlines to arguing the injury is not work-related. If your claim has been denied, you can still pursue the benefits you deserve.

Discover Reasons for Your Claim Denial

To help you understand the system, let’s outline why claims are denied and when an appeal is possible.

Here are 3 common reasons your claim could be denied:

  • You did not report your injury on time. In California, you have 30 days from the date of your injury to report it to your employer.
  • Your employer disputes your claim. Your employer might try to say your injury was the result of your own actions or negligence, and not their responsibility. You can appeal your claim to tell your side of the story again.
  • You didn’t seek medical treatment. Seeing a doctor for your injury creates a record of your treatment. Without a record of injury or treatment, you may be unable to prove your claim.

What Should You Do If Your Claim Is Denied?

If your workers' compensation claim is denied, it is essential to act quickly and strategically to protect your rights. A denial does not mean the end of your case; it is often the beginning of a process to secure the benefits you deserve.

First, carefully review the denial letter to understand the reasons behind the decision. Common reasons include late reporting, insufficient medical evidence, or disputes over whether the injury occurred within the scope of employment. Identifying the issue allows you to address it effectively.

Next, gather and organize evidence to strengthen your case. This may include medical records, incident reports, witness statements, and documentation of communications with your employer or insurance company. If the denial is due to missing information, providing the necessary documents promptly can sometimes resolve the matter without further action.

It is also critical to adhere to California's strict deadlines for appealing a denied claim. Missing these deadlines can forfeit your right to pursue compensation. Consult the California Division of Workers’ Compensation or a qualified attorney to ensure you meet all procedural requirements.

An experienced Chula Vista denied workers' compensation claim attorney can be a vital asset during this process. Legal representation helps you navigate the complexities of appeals, prepare for hearings, and counter challenges from insurers or employers. With a skilled advocate, you can build a compelling case and improve your chances of obtaining the benefits needed for recovery.

Navigating the Workers' Comp Appeals Process

The appeal process involves several steps, including:

  • Filing a Petition for Reconsideration: This petition asks the WCAB to review the decision made by the insurance company or your employer. This must be done within the time frame specified by law, typically 20 days from the denial notice.
  • Requesting a hearing: After filing the petition, you may request a hearing before a judge. You and your employer will present evidence supporting your positions during this hearing.
  • Submitting medical evidence: Solid medical documentation, such as doctor’s reports, treatment records, and expert testimony from medical professionals, is critical in appealing a denied workers' comp claim.
  • Settlement negotiations: In some cases, a settlement may be reached without going to trial. We will negotiate with the insurance company to secure your best possible outcome.
  • Preparing for trial: If negotiations fail, we will represent you in court, arguing your case before a workers’ compensation judge. This process can be complex, but with the right legal representation, you can significantly increase your chances of success.

Contact Our Chula Vista Denied Workers' Comp Claim Lawyer Today

If your workers’ compensation claim was denied, take action today. A lawyer gives you a voice in the system by helping you tell your story to your employer and the court. Get started now with a free consultation regarding your right to recovery at our offices located in Chula Vista and Oceanside. 

Call now at (619) 202-8976 or contact our Chula Vista denied workers' comp claim attorney today. Se habla español.

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