If you suffered an on-the-job injury, you already know just how difficult recovery can be. It is hard to focus on getting better when you have so many other worries on your plate. You may have missed work or are still out of commission, which means that you lost an important source of income. Medical bills related to your injury only complicate the situation. With all of this on your mind, a workers’ compensation denial can feel devastating.
You can appeal a denial in California. However, to successfully file an appeal, you need to understand the nature of the denial. You also need to familiarize yourself with the various timelines for filing an appeal.
Why did they deny my claim?
Your denied claim could be for a number of reasons. Those reasons should not be a mystery, though. The explanation for the denial can usually be found in your denial letter. Common reasons for denying a claim include:
- Failing to report your injury in time.
- Filing a claim too late.
- Employer-disputed claims.
- Failure to seek medical treatment.
- Lack of evidence.
Just because your denial letter outlined one of these or other reasons, you can still pursue an appeal. Most people who file appeals point out errors in the denial reasons. For example, an employer who disputes a valid claim should not be able to stop a worker from getting the benefits he or she deserves.
Steps for filing an appeal
In addition to the reason for the decision, your denial letter should also tell you how long you have to appeal. While it is extremely important for you to meet these deadlines, consider speaking with your employer first. It is possible that the dispute was either a misunderstanding or even a clerical error, both of which you can easily resolve.
If you move forward with an appeal, you will have to attend an administrative hearing. This is your opportunity to demonstrate why the denial was an error. You should bring all relevant documents, such as medical records, time sheets and other information. This information will help you demonstrate your claim.
Filing an appeal is a lengthy process
Even though you must meet strict deadlines during the appeals process, it is much longer than you might think. There are several steps in the process. Successfully moving forward through each step requires dedication and careful attention to detail.
You need to take timely action after a workers’ compensation denial. Going through this process alone can be overwhelming, but you do not have to take everything on by yourself. A qualified attorney who is familiar with the appeals process can help you move through the appeals process more easily, which can be a great relief.