Every year, thousands of injured employees file claims in order to receive workers' compensation from their employers. Unfortunately, a large amount of those claims are denied by claims administrators, many of which were legitimate to begin with. If you disagree with the decision of your claims administrator to deny your application, contact a San Fernando Valley personal injury lawyer at The Law Offices of Gerald L. Marcus to learn how we can help you appeal the denial of your workers' compensation claim.
There are a number of reasons why a claims administrator may deny a claim for workers' compensation. Many times, a claim is completely legitimate but may be denied because for administrative reasons such as failing to meet the filing deadline and failing to supply the necessary documentation in the initial claim. These are unfortunate reasons to be denied the benefits an injured worker is entitled to because they have nothing to do with the actual injuries of the applicant. Secondly, a claim may be denied because, although the worker was injured in a workplace accident, the injuries are not covered by the employers' workers' compensation insurance.
Workers who would like to dispute the denial of their workers' compensation claim can file a complaint with the California Division of Workers' Compensation (DWC) concerning the specific reasons for disagreement. The DWC addresses complaints such as the failure of the assigned physician to appropriately examine the worker or that the doctor was altogether unqualified to evaluate the specific injuries. Applicants may also complain that the process used to determine the benefits was inappropriate for their specific situation or that the benefits allotted by the claims administrator were done so inaccurately.
These complaints may be addressed with further investigation into the situation of the worker and the circumstances of the initial evaluation. The DWC may utilize their own medical team to review the initial examination and conduct their own physical evaluation of the worker or the DWC may even submit the claims administrators' investigation to the adjudication department of the Workers' Compensation Appeals Board. Petitions for reconsideration may also be made directly to the Workers' Compensation Appeals Board if the worker does not wish to file a complaint.
While there are options for workers' whose initial claims were denied, petitions or claims are undoubtedly accompanied by a great deal of scrutiny and may require a plethora of further investigation. Injured persons should be prepared for this difficult process and consulting a personal injury attorney in San Fernando can help with protection against an unfair analysis.
Complaints must be filed with the local workers' compensation division office in San Fernando Valley. At The Law Offices of Gerald L. Marcus, one of our experienced personal injury attorneys can assist you in locating the right office and filing the complaint properly. Filing with the division office requires filling out an Application for Adjudication of Claim and then a Declaration of Readiness to Proceed. After the proper paperwork has been submitted, your case will be heard in a trial court before a judge, which is why is essential that you contact a personal injury attorney in San Fernando Valley to represent you before the court. The legal process for appealing the denial of your workers' compensation is long and complicated. Schedule your case evaluation with The Law Offices of Gerald L. Marcus today and start the road towards the compensation you deserve.