You are certainly not alone if your workers’ compensation claim was denied. Many claims do not go through on the first attempt. Fortunately, it is not the end of the road for the affected workers. You can appeal the initial decision and get the benefits approved.
Before laying the groundwork for your appeal, it is necessary to know why your claim was denied. It could be due to uncertainty about the nature and circumstances of your workplace accident, pre-existing injuries or delays in reporting to your employer or filing, among other reasons.
The appeal process in California explained
There are several stages involved when appealing a denied workers’ compensation claim in California. You do not have to go through all of them unless your appeal is unsuccessful and you wish to take it further up to the next level.
The first stage involves filing an Application for Adjudication of Claim in the county you live and serve the claims administrator. A judge will try to assist you and the claims administrator to reach a settlement instead of taking the case to trial. If a solution is not forthcoming, there will be a trial (not a jury trial), and the judge will decide on the matter.
If the decision does not go your way, you can proceed to the next stage by filing a petition for reconsideration. The California Workers’ Compensation Appeals Board will hear your petition. You may escalate your appeal to the California Court of Appeals and the California Supreme Court if the board’s decision does not go your way.
Get help with a denied claim
A denied claim can leave you in a financially complicated situation. You may not be in a position to work, yet you have to sort out the medical bills and other living expenses.
Therefore, it is necessary to do all you can to increase your chances of a successful appeal. It is also worth noting that there are crucial legal deadlines in the appeals process, and you should act as soon as possible after your claim is denied.