Few situations are more stressful than sustaining a work-related injury that impacts your ability to earn a living. The state workers’ compensation system is designed to benefit those incapacitated due to an employment-related injury or illness. Unfortunately, these claims are often denied. When this happens, contacting a diligent workers’ compensation attorney who could help you understand the steps to take following a rejected claim is crucial.
A denial does not have to be the end of the process. If your claim was rejected entirely or resulted in an unreasonably low award, you could benefit from discussing your options with a Van Nuys workers’ compensation denial lawyer from Silberman & Lam.
Denials occur for a wide variety of reasons. Although this no-fault system is designed to cover injuries regardless of the negligent party, insurance companies find many ways to reject a claim or offer an insufficient settlement amount. Some of the reasons for a denial that a Van Nuys workers’ compensation attorney could address include the following:
There are strict deadlines that must be complied with throughout this process. A claim can be denied if a worker does not report their injury to an employer or supervisor within 30 days. This makes waiting to provide notice of a workplace injury risky.
One critical element of a successful claim is that the injury or illness stems from a work-related event. Employers can dispute this connection in several ways. The company could argue that a worker had a pre-existing condition and that the incident did not aggravate it further. There could also be fraud allegations suggesting the health condition was caused by something other than an on-the-job incident.
Any time an employee is hurt at work, it is vital that they seek medical care as soon as possible. Workers who refuse to see a doctor or put it off for an unreasonably long period can give the impression that the condition was never serious. A long delay between a workplace injury and resulting medical care might also raise questions about whether the injury occurred on the job.
Injured workers have the opportunity to appeal a denied claim. This process begins by filing an application known as the Application for Adjudication of Claim. This paperwork is submitted to the state. Another process in contesting a denied case could be obtaining a qualified medical evaluator (QME) to conduct a medical exam if one has not already been done. For example, cardiologists serving as QMEs will review heart-related claims.
Before the appeal is litigated, a judge will oversee a settlement conference involving the injured party, their Van Nuys workers’ compensation denial attorney, and the defendant or their attorney. In some cases, the parties can reach a negotiated settlement that ends the case. When that is impossible, the judge will set the case for trial to consider the evidence presented.
Having your claim rejected can be frustrating, and the same is true for receiving a reward for less than you deserve. However, options are available to you, and it is wise to consult a skilled attorney for guidance.
Before you accept any outcome, let a Van Nuys workers’ compensation denial lawyer help you with a claim. Call our experienced attorneys at Silberman & Lam for an initial consultation to learn about your options.
