Whether you work in one of California’s most dangerous industries or carry out your daily duties while sitting at a computer behind a desk, if you suffer an injury on the job, you have a right to file a claim to request benefits. Your employer hopefully fulfilled his or her obligations to provide you with proper training and equipment to keep you safe in the workplace. Your employer also no doubt has purchased insurance through the workers’ compensation program, which is the same system through which your claim would be processed.
Work comp benefits might be helpful during your recovery from a workplace injury, especially if you’re losing income because your injuries have prevented you from being able to return to work. Benefits can also help you offset expenses that arise through medical treatment and post-injury care. What can you do, however, if you take the appropriate steps to request benefits and your claim is denied?
Keep in mind that claim denials are not uncommon
Having your workers’ compensation denied can intensify the stress you’re already experiencing in the aftermath of a workplace injury. It’s best to try to remain calm, however, especially if you already have a lot of physical pain and discomfort. It is relatively common for a worker’s initial claim to be denied. It may be helpful for you to learn exactly why your claim has been denied, so that you can determine if you want to appeal the decision.
Any number of issues may prompt a claim denial. For instance, you might have made a mistake when filling out your paperwork. If your description of the events that took place that resulted in injury was too vague, this is another common issue that often leads to denials. It’s always best to provide as much detail as possible regarding when, where, and how your injury occurred.
If you file an appeal, you must prove two things
If you’re going to challenge the system that has denied your initial workers’ compensation claim, you must be prepared to demonstrate that you believe you are entitled to benefits under the existing guidelines for the workers’ compensation program. Two things you must be able to prove are that your injury took place on the job and that it arose out of tasks, duties or situations directly related to your employment.
The good news is that many recovering workers are able to collect workers’ comp benefits after filing an appeal when their claim was initially denied. It may be helpful for you to discuss the details of your specific circumstances with someone who is well-versed in California workers’ compensation regulations before submitting the paperwork for an appeal.