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What to do if your worker’s comp claim is denied

On Behalf of | Jun 29, 2024 | Workers' Compensation

When you’re injured on the job in California, workers’ compensation is there to support you. However, sometimes, claims get denied, leaving you wondering what to do next.

If your workers’ comp claim gets denied, you’re not out of options. Here’s what you can do:

Review the denial letter

Carefully reading the denial letter will help you understand why they rejected your claim. It will help you address any issues in your appeal and know how to proceed. 

Gather evidence

Collect evidence supporting your claim, including medical records, witness statements, and injury documentation.

File an appeal

If you can’t resolve the issue with the insurer, file an appeal within the specified timeframe (usually around 30 days after receiving the denial letter). The appeal process in California involves submitting a DWC-1 form to the Division of Workers’ Compensation

Attend hearings

You must prepare to attend hearings and provide testimony supporting your claim. You may also need to undergo an independent medical examination. You may find it helpful to contact an attorney to attend the hearing with you, as they will know what to say and how to handle the representatives from the insurance company. 

Stay persistent

The appeals process is lengthy, but don’t give up. Keep track of deadlines and communicate with the WCAB and other involved parties.

When your workers’ compensation claim gets denied, it can feel overwhelming. But if you learn about the appeals process and get the right help, you can do things to deal with the denial and try to get the money you should get.