How to dispute a denied workers’ compensation claim

Having your claim for workers’ compensation benefits denied can be distressing, especially if you are experiencing financial problems on top of your injury. However, if your claim for workers’ compensation benefits is denied, it is possible to challenge the claims administrator’s decision. The following is a brief overview of how to dispute an adverse workers’ compensation decision.

File an Application for Adjudication of Claim

If your claim for benefits was denied, the first step in the dispute process is to file an Application for Adjudication of claim. You can file this form at the Department of Workers’ Compensation office in your county of residency or in the county where the injury occurred. The other parties (such as the claims administrator) must then be served with the application.

Receive notice of filing

Once filed, the DWC office will notify you that they received the application, and it has been filed. The notice will also include a case number to use on all documents relating to your claim.

Request a hearing

Next, you need to file a Declaration of Readiness to Proceed to request a hearing. The hearing is referred to as a mandatory settlement conference (MSC).

Attend the mandatory settlement conference

At your scheduled mandatory settlement conference, the judge will discuss your claim with you and your claims administrator, with the aim of reaching a settlement. You may have an attorney represent you at this hearing.

Attend a trial, if necessary

If you are unable to reach a settlement at your mandatory settlement conference, the final step is to attend a trial. The trial will be held by a new judge not previously involved in your case. At the trial, each party will present its case. Witnesses may testify. Within about 30 to 90 days after the trial, you will receive written notification of the judge’s decision. If the decision is unfavorable, you can file a Petition for Reconsideration.

Learn more about workers’ compensation claims

Ultimately, this post is for educational purposes only and does not contain legal advice. Those who want to learn more about workers’ compensation in Folsom may find our firm’s website to be a useful resource.