Assisting Clients Across California Since 1993

What can you do if your workers’ compensation claim is denied?

Many people are injured while working. As a result, they may not be able to return to work until their injuries have healed. These injured employees could lose wages for weeks, months or for their entire life. Injured workers may be able to apply for workers’ compensation. 

Workers’ compensation is a program that can give injured employees health care coverage and lost wage benefits. Injured workers have 30 days to report their injury to an employer and one year to file a claim in California to receive benefits. 

Benefits are not guaranteed. Workers can be denied benefits. This can cause these workers immense financial stress. Employees can file an appeal to receive their benefits. Denials often happen for a few reasons. Here is what you should know:

Understand why you were denied

A denial could have been caused by something as simple as a typo or miscommunication. However, many denials are caused for the following reasons:

  • Missed statute of limitations
  • Missing documents 
  • Pre-existing medical condition 
  • The employee was using alcohol or drugs when the incident occurred 

It is often necessary to learn why a claim was denied so that steps can be made to appeal the decision.

Learn how to appeal a denial

Once it is clear why a denial happened, the employee can gather additional documents and file an appeal. The employee may need to argue their case during a hearing. It can take over a month for a decision to be made. Employees can seek legal guidance as they appeal a workers’ comp denial.