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How to Fight a Workers’ Compensation Claim

Handyman With Fractured Hand

If you were hurt on the job in California, you are entitled to workers’ compensation coverage. Any employer with one or more employees is required to carry workers’ compensation for their employees. If your employer or the insurance provider wrongfully denies your claim for coverage after a workplace injury, you have the right to fight back. Read on to learn how to pursue a workers’ compensation claim that has been denied, and contact a seasoned Arcadia workers’ compensation lawyer if you or a loved one has been hurt on the job in Los Angeles or the Inland Empire.

Filing your claim

When you are injured on the job in California, there are a few steps you must take in order to ensure you get proper workers’ comp coverage. Typically, an injured worker in California must complete three steps to pursue a workers’ compensation claim:

1) Report the injury to your employer
2) File an official claim with your employer
3) File an “application for adjudication of a claim” with the Workers’ Compensation Appeals Board (WCAB)

Each of these steps must be completed within certain time limits after your workplace accident, and each requires providing certain information and documentation relating to your injury. Once your claim is filed, the insurance provider will conduct an investigation and determine whether to accept or deny your claim.

Appealing a denial

If the workers’ compensation insurance provider denies your claims, you have the right to contest that decision. There are several steps to the appeals process in California, and you must follow specific procedures and strict time limits to preserve your legal rights.

After receiving the claims administrator’s decision, whether it is a total denial or more limited coverage than you believe is appropriate, you can file an appeal. You must file your appeal in writing. Typically, in California, you can appeal a claim denial by requesting a hearing in front of the local Workers’ Compensation Appeals Board. The hearing plays out like an informal trial, with each side providing evidence and witness testimony, where appropriate. An experienced workers’ compensation attorney can help you file your appeal, gather the necessary evidence, and present your case before the WCAB.

If the WCAB rules against you, you can appeal the WCAB’s decision to the Worker’s Comp Appeals Board (WCAB) in San Francisco. To appeal, you will file a Petition for Reconsideration. If you or your employer are unhappy with the results of that appeal, you can request additional review from a California state court.

If you miss any deadlines any step of the way, your case might get tossed out. It is strongly advised to retain a qualified workers’ compensation attorney at the start of the process to ensure that you preserve all of your legal rights and present your strongest case for full coverage.

Help with Workplace Injuries in Arcadia

If you’ve been hurt on the job in Southern California, get help securing the medical coverage and other benefits you deserve for your injuries. Contact the dedicated and effective Arcadia workers’ compensation lawyers at the Law Offices of Dulio R. Chavez II and Associates for a free consultation at 626-357-3303.

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