If your California work comp claim is denied, it does not necessarily mean that you do not have a valid and compensable work comp claim. However, if your claim is denied, it is a good time to consider hiring an experienced workers’ compensation lawyer to help turn things around so that you can get the work comp benefits that you deserve.
California Workers’ Compensation Attorneys
The California workers’ compensation lawyers at Kneisler and Schondel have years of experience handling all different types of workers’ compensation cases—including claims that were denied at one point in time. As a worker in the state of California, it is crucial to know your legal rights so that you do not miss out on the benefits to which you are entitled after suffering a work injury.
If you have recently suffered a work-related injury or illness, our law office can help. With many years of experience successfully pursuing benefits for injured workers, our attorneys know what it takes to fight back against a denied workers’ compensation claim. Contact our office today to schedule a consultation with us to learn more about what we can do to help your claim move forward.
Your Employer Does Not Believe Your Injury or Illness Is Work-Related
One of the most common reasons for a denial of a workers’ compensation claim is that the employer does not believe that the injury or illness is work-related. Under California law, an employer cannot just deny a claim without a reasonable basis to do so.
Typically, your employer will provide you with some indication of why it was denied as non-work related. For example, an investigation conducted by your employer could lead it to believe that your injury occurred somewhere other than the workplace.
Regardless of the reasoning behind your employer’s denial of your claim, you will ultimately need to provide more evidence supporting that the injury is work-related before your claim can be accepted. Medical records supporting your claim are often helpful. A skilled workers’ compensation attorney can also help you review the facts of your case and put together evidence that supports your claim.
You Missed a Critical Deadline in Reporting or Filing Your Claim
Another common reason for a workers’ compensation claim denial is that the injured worker did not report their injury to their employer or reported it too late. A claim for worker’s compensation benefits might also be denied if the claim was filed too late.
In California, you need to report your injury within 30 days. Essentially, once you suffer an injury at work, it is crucial to report it to your employer as soon as possible. If your injury was a repetitive-use type of injury that occurred over time, you should report it to your employer once you have reason to believe that it is job-related.
If a claim is denied on the basis that it was not reported to your employer at all or it was reported too late, you might be able to get things turned around if you can prove that you did report it in time. Any evidence you possess showing that you did appropriately notify your employer of your injury within the required time period can help your claim become accepted.
Your Injury Happened at Work—But Did Not Arise Out of Or Occur in The Course of Your Employment
Even if your injury happened at work, your workers’ compensation claim could be denied if your injury did not arise out of or occur in the course of your employment. These cases can be legally complex, so if your work comp claim was denied for one or both of these reasons, you should strongly consider hiring a lawyer to represent you going forward.
Generally, for an injury to arise out of and occur in the course of employment, the injury must happen while the worker is at work and performing a job duty they are expected to or have been instructed to perform. However, there are many exceptions, so this is a commonly litigated issue in workers’ compensation cases.
Idiopathic injuries, in most cases, are not considered work-related injuries, even if they happen at work while the employee is working. One example of an idiopathic injury is a heart attack. If someone suffers a heart attack while working, the injury will not be deemed a work injury, unless some exception applies. The reason for this is that while the heart attack happened at work, it was not actually caused by any work-related reason.
If your workers’ compensation claim is denied, speak to an experienced workers’ compensation attorney immediately. It may be possible to reverse the denial of your claim.