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Workers’ Comp Claim Denied. What to Do

Workers’ Comp Claim Denied? Call 1-800-380-8080 for an Experienced Work Comp Attorney

You got injured at the workplace and shortly after you fill out the Workers’ Compensation Claim Form (DWC-1). Unfortunately and for reasons you initially do not seem to understand, you receive a letter highlighting the ‘Workers’ Comp Claim Denied’ status of your claim. Under these circumstances it is easy to panic and to stress out. After all, the future of your family depends on the sole income you provide. Don’t sweat it though. When you workers’ comp claim is denied you have options: you can submit your claim again for consideration, request a hearing or you can also appeal. But, in order to have your case heard by a judge, you must first file an Application for Adjudication of Claim. Also, it is imperative for you to know that without evidence, your claim will likely be rejected for the second time. Needless to say, an experienced workers’ comp attorney can help guide you through the appeal process and make sure you’re adequately preparing the resubmission of your claim.

5 Steps that Could Increase Your Chances of Obtaining Workers’ Comp Benefits

  1. Call an experienced 1-800-THE-LAW2 workers’ comp lawyer: He or she can determine the exact reasons as to why your claim was denied. Once the source of the problem is identified, it is easier for you and your counsel to rectify it or if necessary gather more evidence, contact other witnesses, and/or hire experts to strengthen your resubmission for appeal.
  2. Ask your employer for a copy of your personal file: We advise you to make copies of your entire file. Most importantly, make sure you get a copy of the form you completed at the time of the accident. Share those copies with your attorney.
  3. Collect evidence for your claim: including: detailed medical reports, the report of the emergency room, test results, reports on the progress of your rehabilitation, witness statements, medical bills, receipts for expenses (transportation , medications, etc.) and any additional documents that may contribute to the viability of your claim. Moreover,  your attorney can work with medical experts to determine whether there are any additional reports that can help to support your claim.
  4. Get ready and prepared for the hearing: In some states, the appeals are reviewed by a board; in other states, the appeal may be heard by a judge at a hearing. Your workers’ comp lawyer can help you prepare for this hearing. It is essential that you describe truthfully the details of your accident. Also, document the lost wages and additional expenses you’ve made as a result of your injuries. Remember, being ready is not the same as being prepared.
  5. Be very careful with what you do in public: The insurance companies are known for videotaping the plaintiffs. Your participation in physical activities that you have previously claimed to be unable to perform due to your injuries can actually jeopardize the status of your legitimate workers’ comp appeal process.

Remember, your denial letter should clearly state the deadline for appeal. Do not let this deadline expire! As soon as you receive it, work expeditiously to follow through with the appeal process. The sooner you do, the sooner you could receive the benefits you are pursuing. A ‘Workers’ Comp Claim Denied’ letter is not the end of the road. Make a confidential call to 1-800-380-8080 today. You can also complete the fields in the FREE CONSULTATION box. And you don’t worry about money, you get paid, or you don’t pay at all.

Pursuant to Labor Code Section 5432(a)

Making a false or fraudulent workers’ compensation claim is a felony subject to up to 5 years in prison or a fine of up to $50,000 or double the value of the fraud, whichever is greater, or by both imprisonment and fine.

 

Sources:

Workers’ Compensation Claim Form (DWC-1) Retrieved on October 24, 2014

Application for Adjudication of Claim. Retrieved on October 24, 2014

Workers’ Compensation in California: A Guidebook for Injured Workers. Retrieved on October 24, 2014

Labor Code. Workers’ Compensation and Insurance. Retrieved on October 24, 2014.

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