Denied Workers' Compensation Claims in Santa Ana
Denied Benefits? We Can Help You File an Appeal - (714) 500-8661
If your workers' compensation benefits have been delayed or denied, you may have received a letter from the claims administrator stating the reasons for the denial. You have a right to dispute the denial by going through the appeals process.
Steps to filing a workers' compensation appeal:
- File an Application for Adjudication of Claim form at your local DWC office in your county. The claims administrator generally receives a copy as well.
- The DWC office will confirm that it has received your application and assign you a case number, which should be used on all documents relating to your claim.
- Next, file a Declaration of Readiness to Proceed to request a hearing before a judge, called a mandatory settlement conference (MSC). During the hearing, the judge will review your case and try to reach a settlement with the claims administrator.
- If a settlement cannot be reached during the MSC, a trial will be scheduled where you and the other party can each present your arguments. The judge will issue a written decision and send it to you by mail.
Common Reasons Claims Are Denied
Workers' compensation claims can be disputed and denied for a variety of reasons, however the most common reasons are:
- Waited too long to file/report injury. Workers must notify and file a claim within the given time frame. When you wait too long to file and receive medical treatment, it can be harder to prove that your injury was caused by your work and give insurance companies a stronger reason to deny your claim.
- Employer disputes the claim. Sometimes employers can claim that your injury was not caused by work. Employers have an incentive to dispute valid claims because workers' comp insurance premiums can rise as more claims are filed.
- Injury does not qualify. Some injuries may not be serious enough to prevent you from working, which disqualifies you from collecting compensation.
- Insufficient medical evidence. When you do not have the appropriate medical records documenting your injury, your claim can be denied.
Speak with an Experienced Workers' Compensation Lawyer Today
Call our office at (714) 500-8661.