Common Reasons for Denied Claims
When a workers’ compensation claim is filed, insurance companies often search for any reason to deny it. Some of the most common reasons for denied claims include:
- Missed deadlines: In California, you must provide your employer with written notice of an injury within 30 days of the incident. The claim must be filed within one year. Failure to do so can result in a denied claim.
- Dispute regarding the nature of injury: When an employee claims that an injury was work-related, there must be sufficient evidence. Medical documentation is often the best way to support the claim.
- The claim was filed after you left the job: In most cases, insurance companies will deny a claim that was filed after you quit your job, were laid off, or fired. However, if you can provide a valid reason for the delay, you may be able to pursue a successful appeal.
This area of the law can be confusing and complex. If you feel that your claim was wrongly denied, an attorney can help.
When a workers’ compensation claim is filed, insurance companies often search for any reason to deny it.
What If My Claim Is Denied?
If a claim is denied, it can be highly discouraging. However, sometimes a claim is denied simply because of a paperwork mistake. For this reason, it is important to carefully review any denied forms, as you may be able to resolve the issue with a claims adjuster. In other cases, you may need to appeal the denial. If this is the case, Smith & Baltaxe can help you file an appeal and receive the compensation you deserve.
Timeline for Filing an Appeal
If your attorney determines that an appeal would be in your best interest, he will help you file an application for the adjudication of the claim. Next, a hearing will be scheduled before an administrative law judge. During this trial, you will present medical evidence to support your claim. Depending on the case, there may be additional levels of appeal beyond the initial administrative levels. Our attorneys at Smith & Baltaxe are here to help you every step of the way.
Schedule a Consultation
If you have been denied workers' compensation benefits following a work injury, please schedule a consultation at our law office. For more than a decade, attorneys Bernhard Baltaxe and Byron Smith have helped injured workers collect the compensation they need. To schedule a free consultation, contact us online anytime or give us a call at (415) 292-7800.