What are your options if a workers' comp claim is not approved?

A work accident can change your life instantly. Depending on the nature of the accident and the type of injuries you suffered, you could be facing the possibility of long-term damage, time away from work and expensive medical bills. It's important for injured California employees to seek workers' compensation benefits to cover their financial needs during their time of recovery.

This is why it is devastating when a workers' compensation claim comes back denied. You need financial support, but a denial letter may feel like the end of the road for you. Thankfully, there are options available to you. It may be possible to appeal a denied claim and continue your pursuit of the benefits you need. The workers' comp system can be complex, and this is why you may find it useful to work with an attorney at every step.

Why a denied claim?

If you think you want to appeal a denied claim, you may want to start with learning more about why your claim came back denied in the first place. This should be in the letter you received from the insurance company. Some of the most common reasons these claims are not initially successful include the following:

  • There is not enough evidence your injuries are the result of your work or a work accident.
  • Your injuries are not severe enough to warrant medical attention.
  • You did not file the claim in enough time, or you did not notify your employer of the accident in a sufficient amount of time.
  • Your employer is disputing the claim. 

These are a few of the reasons why the insurance company may deny your claim. Once you understand the reason, you can move forward to gather additional documentation and proof that will validate your appeal. It can help to remember that insurance companies do not have your interests in mind and that it may be necessary to fight for the full amount of support you deserve

Where should you start?

There are benefits to working with an experienced attorney, even when completing and filing your initial claim. This guidance can help you prevent unnecessary setbacks, including a denial. In the event a denial does happen, a legal ally can help you move forward with an appeal and take the appropriate steps to get what you need for a full recovery from your work-related injuries.

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