You thought you had a solid workers’ compensation case, but your employer’s claims examiner felt differently. Recently, you learned you lost your case. What should you do now?
Chron explores strategies for responding to a denied workers’ comp claim. You could have more options for paying hospital bills and recovering wages lost because of a workplace injury than you realize.
Appeal the decision
Usually, claims adjusters have 14 days to either reject or accept a workers’ comp claim after the employee initially reports an injury. Because you received a rejection, you have the right to appeal the decision according to current California law. If you win your appeal, your employer’s workers’ comp provider must accept your claim and provide you with benefits according to state regulations.
Reject permanent or temporary disability
Depending on when you sustained your workplace injury, your physician could deem you permanently disabled. Even if a claims adjuster accepted your comp claim, you may feel the offered amount does not align with your estimated future medical treatments or loss of earning capacity. If so, you may reject the offer and either appeal the decision or return to the negotiating table with your employer’s insurance provider.
Instead of permanent disability, you could have a temporary disability. After a medical review, your employers’ physician may disagree that your injuries prevent you from working and deny your claim. You may seek a second medical opinion to appeal receiving temporary disability benefits.
Do not feel discouraged after losing a worker’s comp case. The right appeal strategy and medical professional could get you the financial help you deserve.