After you have had a disagreement with the decision from your employer or claims adjuster regarding your workers’ compensation, making an appeal could be an option for you. As a skilled workers’ compensation attorney could further explain, this legal process may require additional medical examinations, administrative hearings, and a possible trial in front of an administrative law judge.
A Santa Ana Workers’ compensation appeals lawyer from Silberman & Lam could be a valuable resource in navigating these disputes over your entitled benefits or rights to a claim. Let us help you understand how the appeals process works and when the help of a lawyer could be beneficial.
The need to appeal a workers’ compensation claim could occur any time after the employer or claim adjuster makes a decision on the case, and a Santa Ana lawyer could help. In most cases, this would be after the denial of a claim, but it could also happen because of disagreement with the offered benefits or treatment plan under an accepted claim. An insurance claim adjuster typically has 90 days following the submission of a workers’ compensation claim form to deny it or accept liability. If the adjuster fails to act on the claim within this period, a presumption exists that the claim is accepted.
As a Santa Ana lawyer could explain, the opportunities for an appeal of an insurance carrier or employer denial could involve a variety of issues related to the workers’ compensation claim process or the awarded benefits. For example, an appeal could take place over disagreement with:
The appeal of a workers’ compensation claim could also be necessary to navigate procedural issues with a claim, such as untimely filing or another complication with the process.
A few levels exist to the appeals process for California workers’ compensation claims and each level has a filing deadline that injured workers must follow to preserve their right to appeal. The first is to have an administrative law judge hear and review the case, which often requires the filing of an Application for Adjudication of Claim usually within one year of the date of injury.
For help filing an appeal of your claim, consider scheduling a consultation with our Santa Ana workers’ compensation appeals lawyers at Silberman & Lam. We could advise you on the potential merits of an appeal, opportunities for a settlement, and the necessary procedural steps for additional review.
Call our firm to speak with an understanding attorney. We could set up a meeting to talk about your concerns at your convenience.
