California Workers' Compensation Law: What If My California Workers' Compensation Claim Is Denied?

California Workers' Compensation Law can be confusing and intimidating to seriously injured California workers. This article concerns what you should do if your claim is denied. Also known as a denied claim. First of all, just because your claim is denied doesn't mean you still can't win your California Workers' Compensation Law Claim.

If your claim is denied you need to find out why your claim is being denied. Then, you need to marshal the evidence to overcome the denial. If you can "fix" your evidence then you may be able to convince the workers compensation insurance adjuster to accept your claim.

If your claim is denied, and you are not able to convince the adjuster that you have a valid claim, then you will need to file for a hearing at the Workers' Compensation Appeals Board in order to fight for further medical treatment, temporary total disability benefits and other benefits.

Generally, before you file for a hearing however, you are going to need evidence, usually medical evidence. You need evidence to fight the reason why the workers compensation insurance carrier denied your claim.

If your claim is denied because the insurance company believes that your injury is not work related, then you are going to need proof that you were actually injured at work. You may need to subpoena co-workers or others that witnessed your injury.

Again, you are going to need medical evidence. You are going to need a doctor to write a well-reasoned report that explains how and why your injury is work related. This needs to be done through a carefully reasoned medical analysis. Too often, doctors' reports are filled simply with conclusions, which is bad evidence. Your doctor needs to specifically and clearly explain how the work activity caused your injury.

Disclaimer

This article is not legal advice. I am simplistic in order to achieve clarity. Your case may differ from the circumstances described in this article. If you are a seriously injured worker in California, then you need to hire a seasoned California Workers' Compensation Attorney. When you are bringing a California Workers' Compensation claim your credibility is always at issue. Meaning, if the Judge does not believe you, you will lose your case. Getting caught in a lie or fudging or exaggerating your injuries will usually mean you will lose your case. Always tell the truth.


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Bill Turley is a San Diego Workers' Compensation Lawyer. He has the most comprehensive California Workers' Compensation Law website and San Diego Workers' Compensation Attorney blog.