Injuring yourself at work can be a traumatizing experience. Not only could it cause physical pain and immobility in some cases, but a workplace injury can also affect your emotional health and cause financial distress for you and your family.
Fortunately, workers’ compensation benefits are possible in most situations – and even if your claim is denied, you can still appeal and win benefits to help you become financially whole. Learn the three things you need to do if your workers’ compensation claim is denied.
1. Hire an Attorney
Consult an attorney immediately if your claim is denied. Your attorney will not only be able to help determine why your claim was denied, but they’ll devise a plan to appeal the denial to secure you the compensation you need. On average, individuals who hired lawyers to appeal their denial were awarded 47 percentmore in benefits, so legal help can be a worthwhile investment.
Make sure to gather all the necessary documents before your legal consultation. Your attorney will want to see copies of your initial injury report, medical records showing the extent of your injury and treatment, income statements, and the letter notifying you of your compensation denial.
2. Understand the Reason
You may be surprised to learn why your workers’ compensation claim was denied, but an attorney can help.
Timing is one of the most common decisions why a workers’ compensation claim is denied. Basically, you need to report your injury to your employer within 30 days as per California state law. Therefore, if you fell or hurt yourself on a piece of machinery, your claim will be better off if you notify your employer immediately. You also must file a claim for workers’ compensation within the proper time frame, or your claim could be denied.
A denial may also occur if your employer disputes your claim. For example, your employer may state your injury or illness occurred outside of work. You and your attorney can work together to gather evidence proving the workplace or your position resulted in the injury or illness.
Finally, if you did not receive any medical treatment because of your injury or you are unable to provide proof any medical treatment, your claim will most likely be denied.
3. Appeal the Denial
Once you and your attorney determine and understand the reason for the denial, you can begin the appeal process. An appeal requires a multi-step process, but your attorney will help you through the entire process.
To get started, an application for adjudication of claim must be filed within one year after your injury, after the last day you received medical benefits, or after the day when your temporary disability benefits end. This form opens your workers’ compensation claim with the state’s appeal board.
You and your lawyer will also need to file a “declaration of readiness to proceed,” which notifies the judge you are ready for a hearing. You may then schedule a meeting with your attorney and judge to reach a settlement agreement.
If you are unable to reach a settlement agreement, your appeal will get a hearing, which is similar to a trial. The judge will make a decision based on the arguments and evidence from both sides to determine if your denial was warranted or if you do, in fact, need workers’ compensation benefits.
Help is available if your workers’ compensation claim was denied. Contact Hernandez Law Offices today for assistance. Our experienced team is ready to help you get back on track financially after your workplace injury, so get in touch today to set up a consultation about your claim.