Understand Why the Claim Was Denied
Insurance companies deny claims for a variety of reasons. Some common examples include:
- The insurer claims the injury was not work-related
- The injury was not reported in time
- The employer disputes that the injury occurred at work
- There is insufficient medical evidence
Reviewing the denial notice can help clarify the reason for the decision.
Seek Medical Documentation
Medical evidence plays a key role in workers’ compensation cases. If your claim was denied, it may be important to obtain medical records or evaluations that clearly explain how the injury is related to your job duties.
In many cases, a doctor’s opinion connecting the injury to work activities can help support the claim.
File an Application With the Workers’ Compensation Appeals Board
If your claim is denied, you may still pursue benefits by filing an Application for Adjudication of Claim with the California Workers’ Compensation Appeals Board (WCAB). This formally opens your case and allows the dispute to move through the workers’ compensation system.
At this stage, the case may involve medical evaluations, hearings, or settlement discussions.
Consider Speaking With a Workers’ Compensation Attorney
Workers’ compensation claims can become more complex after a denial, particularly when the insurance company disputes the cause of the injury.
An experienced attorney can help gather medical evidence, guide the case through the appeals process, and advocate for the benefits you may be entitled to receive.
Protecting Your Rights After a Denial
A denied workers’ compensation claim does not always mean the claim lacks merit. Many injured workers are still able to obtain benefits after challenging the denial.
Sentry Legal Group represents injured workers throughout California and assists clients in pursuing workers’ compensation benefits when claims are disputed or denied.
If you or someone you love believe to have suffered a work-related injury, please do not wait! Schedule a free consultation with an experienced attorney with Sentry Legal Group by sending an email or calling us at (818) 824-8884.
.svg)