What Happens When a Workers’ Compensation Claim Is Denied in California?

If your workers’ compensation claim is denied, you’ll have the chance to challenge your denial.

You filed for workers’ comp, but now you’ve received a letter in your mail that your claim has been denied. You don’t know where to turn or what to do. How can this be? You’re worried you will have to cover your medical bills and other expenses on your own, which just doesn’t seem fair.

If you’ve been denied workers’ comp in California it is important to understand how to challenge the denial.

You Will Have the Chance to Challenge the Denial

As soon as you are injured on the job, you must tell your employer about it and fill out a workers’ compensation claim form (DWC-1) in California. They should turn in your claim within one working day to the workers’ compensation insurance company. Your employers’ insurer will have 90 days to investigate your claim and decide whether it’s accepted or denied. If it’s denied, you’ll receive a letter in the mail telling you, as well as instructions for challenging the denial through the California Division of Workers’ Compensation (DWC).

Appealing Your Workers’ Comp Denial

To appeal your workers’ comp denial, you’ll need to carefully fill out the Application for Adjudication of Claim form and file it at your local Workers’ Compensation Appeals Board (WCAB). This must be filed within one year from the date of your injury or when you knew or should have known of the work injury. This timeline may be extended in certain circumstances. A workers’ compensation attorney will be able to determine whether any statute of limitations applies to the facts of your case. You may file the Application in person to a DWC office in your area. The state of California has 22 district offices and satellite locations throughout the state; you can find the entire list here.

After the DWC has received your appeal, you’re going to receive confirmation (Notice of Application) as well as a case number. You may then apply for a hearing with a judge at the WCAB.

Why Are Claims Denied?

There are several different reasons why claims might be denied such as lack of medical evidence, employment status, failure to comply with investigation and statute of limitations. You will want to discuss the facts of your injury with a workers’ compensation attorney to see if your claim is viable.

Getting Help from a Workers’ Comp Attorney

Instead of navigating the complex system of workers’ comp on your own, you should get in touch with a workers’ comp attorney to help you out. They will know exactly how to appeal your denial and properly file a workers’ comp claim as well as other required documents.

Make sure the attorney you hire is experienced with the case results to back it up. Review their website for positive testimonials and reviews.

Contacting Tichy Law

If you’ve been injured at work but were denied workers’ comp, then contact a workers’ compensation attorney at Tichy Law Inc. at (916) 444-0321 for a free consultation. We look forward to assisting you.

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Contact us to speak with an experienced attorney today.

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