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When your workers compensation claim is denied

On Behalf of | Apr 15, 2021 | Firm News

Workers’ compensation insurance is reportedly going to be increasing soon in California. And while some experts say that the increases should be manageable for employers, this hasn’t stopped some small-business owners from voicing their concerns about even a small increase in workers’ comp costs.

Workers’ comp, though it may be burdensome for some employers to carry, is critical for employees who are injured on the job. When a worker experiences harm, medical costs and disability benefits are covered by the program, and this allows an individual to receive the support they need until they are able to return to his or her job.

Employers are not always supportive of employees in the way they deal with claims. In other cases, it is the insurance company that is uncooperative. When a claim is denied, it means that the claims administrator has determined that the injury is not covered by the program. Such determinations are not the final word, though, and there is a process by which injured persons can contest a decision about their claim.

In the state of California, such disagreements are handled by a judicial trial, and require the filing of special paperwork. Prior to trial, the matter will receive a preliminary hearing wherein a settlement can be reached. If not, the case will proceed to litigation.

Throughout this process, it helps greatly to work with an experienced legal expert who understands the entire process. This will help ensure the best possible outcome in the case.

Source: Los Angeles Times, “Workers’ comp rates to rise next year,” Marc Lifsher, December 22, 2013.