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Steps to Take After Denial of Workers’ Compensation Claim in California

Although it is the right of all Los Angeles workers injured on the job to receive benefits to pay for their lost wages and medical treatment, there is no guarantee that an employer’s insurance provider will accept the claim. Often times, workers have their claims denied and struggle to get the benefits they and their families need to survive. The steps to take after the denial of workers’ compensation claims in California are complicated, but nonetheless necessary to ensure justice is served.


In the event a workers’ compensation claim is denied, California law gives the injured worker redress to have their claims examined by a workers’ compensation judge. Even then, the road to obtaining the compensation injured workers need is not an easy one. Hiring a qualified California workers’ compensation attorney can help fill out the necessary paperwork and ensure claims are given a fair hearing.


Application for Adjudication of Workers’ Compensation Claims California


After a workers’ compensation claim is denied, the injury victim and his or her attorney need to file an application for adjudication of claim at either the Division of Workers’ Compensation office where the victim lives or where the workplace accident occurred. The application will need to be served on the insurance claims adjuster and any other parties involved.


Once the claim is filed, the Department of Workers’ Compensation will send a letter acknowledging the claim and provide a case number. The next step to having a workers’ compensation claim heard before a judge is to file a Declaration of Readiness to Proceed. The claim will be settled for a meeting called a mandatory settlement conference (MSC).


Workers’ Compensation Settlement Hearings


During the mandatory settlement conference, the injured worker and his or her attorney will sit down with a judge and the insurance adjuster to try and reach a settlement on the claim. Having a workers’ compensation attorney at this stage is especially crucial as it gives the injured worker a chance to reach a relatively quick settlement.


If no settlement can be reached at the mandatory settlement conference, the judge will schedule a formal trial. In the meantime, the injured worker’s attorney will prepare lists of witnesses and documents to be used at the trial. The judge at the mandatory settlement conference will assign the claim a place and time for the claim to be heard by another judge.


At the conclusion of the trial, the judge will deliberate on the evidence. Decisions are handed down 30 to 90 days after the trial, but are not final. If either the injured worker or insurance adjuster disagree with the judge’s ruling, a petition for reconsideration may be filed with an appeals board. The appeals board will come to a decision within 60 days of filing the petition for reconsideration.


Lawyers to Appeal Denial of Workers’ Compensation Claims in California


Powerful insurance companies often fail to do what is right when it concerns the rights of injured victims in Los Angeles, California. Retaining a workers’ compensation attorney from the very onset of an injury can help give injured workers and their families the best chance of having a fair and just examination of an injury claim. If you were injured at work, speak to a qualified California workers’ compensation attorney about your case.

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