Why was Your Workers’ Compensation Claim Denied?
California law requires employers to carry workers’ compensation insurance to cover the medical expenses and the lost income of employees who suffer workplace injuries. So why is it that some workers who suffer on-the-job injuries receive a denial of their workers’ compensation claim? A denial can happen right away, or the insurer may cancel your benefits too soon. In any case, it is important to understand why claims get denied and to call an experienced employee defense attorney as soon as possible.
Mistakes when filing your claim – While a workers’ compensation claim may seem straightforward, many people make errors that lead to a delay or denial. We can be denied if you failed to report the injury to your employer in a timely manner, did not provide the required information or documents with your claim, or missed the deadline for filing the claim.
Challenging whether your claim was work-related – In order to qualify for workers’ compensation, an injury or illness must have occurred when you were performing duties within the scope of your employment. Sometimes, insurance companies will claim that you had a preexisting injury or that your injury happened at home or during recreational activities. To appeal, you must provide evidence that the injury happened on the job.
Challenging whether medical treatment or missed work was necessary – In some cases, the insurer will not dispute the injury but may challenge whether the medical treatment you received or the time away from work was all necessary based on the nature and severity of the injury. Sometimes, this is based on an independent medical examination (IME) requested by the insurance company.
Find Out How Our California Workers’ Compensation Lawyers Can Help
The above are only a few examples of denial reasons. If your claim is denied or your benefits cut too early, your first call should be to the Employee Defense Group in Los Angeles. Call 818.334.4870 or contact us online to schedule a free case evaluation today.