Workers’ compensation is designed to help workers recover from injuries sustained on the job. However, sometimes claims get denied, leaving workers in a difficult situation. Fortunately, if a claim is denied in California, there are steps you can take to appeal the decision and seek the benefits you deserve.
Understand the reason for denial
The first step in appealing a workers’ compensation claim denial is to understand why the claim was rejected. Insurance companies or employers may deny a claim for several reasons, including lack of medical evidence, missed deadlines, or disputes over whether the injury is work-related. Carefully review the denial letter to identify the exact reason for rejection.
Gather supporting evidence
Once you understand the reason for denial, it is important to gather any additional evidence that may support your case. This could include new medical records, witness statements, or documentation of any work-related factors that contributed to the injury. Strong supporting evidence can help strengthen your appeal.
Request an appeal with the workers’ compensation board
In California, workers can request an appeal by filing an application for adjudication of claim with the Workers’ Compensation Appeals Board (WCAB). This process involves submitting relevant documents, including your denial letter, medical records, and any new evidence you’ve gathered. A hearing will be scheduled where both sides can present their case.
Work with an experienced attorney
An experienced workers’ compensation attorney can guide you through the appeals process, help gather necessary evidence, and represent you at the hearing. Attorneys familiar with workers’ compensation law can significantly increase your chances of a successful appeal.
By understanding the denial reasons, gathering supporting evidence, and filing an appeal with the WCAB, injured workers can improve their chances of securing the workers’ compensation benefits they are entitled to.