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What can I do if my Work Comp claim has been denied?

So, you have been injured on the job, filed a DWC-1, injury report, and you have gotten a notice that the claim has been denied. What do you do next?

Simple. You should contact an attorney in your area who has experience in California Work Comp claims. Why wouldn't you? Most attorneys will not charge you to discuss the claim, answer your questions and even meet to review the facts and discuss the benefits you are entitled.

Our Recommendation

If you have been injured on the job, or if you have a medical condition or disability which you believe was caused or aggravated by your work activities, immediately file a report of injury with your employer. If the claim is then denied or if you have any questions or concerns, contact us for a FREE consultation to discuss your rights, benefits, and options.

Other Frequently Asked Questions:

  • How do I change my primary treating doctor?
  • What if I am unsure whether my injury occurred at work?
  • What is SB 863 & how does it affect injured workers' benefits?
  • What can I do if my Work Comp claim has been denied?
  • What benefits are injured workers entitled to?
  • How much does it cost to hire a Workers' Comp Attorney?
  • When should I hire a lawyer for my Work Comp Claim?

Planning Before the Injury

You have the right to pre-select your treating doctor in the event of an industrial injury. This is generally in the initial paperwork you fill out with new employment. If not given in the initial paperwork often the personnel department or the person in charge of workers' comp should have the proper form. Click Here for a copy of the pre-designation of physician form.

However, many of you reading this have already had a work-related injury and need to change your primary treating physician (PTP) for your Redding Workers' Compensation Claim.

Contact Riley Law Offices Today!

Our Redding workers' compensation lawyers are ready to evaluate your specific case and work for the assistance you need to cover. Call us at (530) 500-8080 or e-mail us to schedule a free initial consultation.

There are a number of reasons the insurance company might give for denying your injury claim, including:

  •  The injury didn't happen at work or in the course & scope of your employment.
  • Your medical or physical problems are the results of a pre-existing problem.
  • You were not an "employee" as defined by the work comp laws in California

The most common reason seems to be:

"There is no medical proof or support for your claimed injury."

There are other defenses to a work comp claim but these are the most common. The insurance industry counts on the fact a certain percentage of people will not pursue a claim after it has been denied, therefore some of these denials are invalid.

Many people simply do not want to hire a lawyer or “make waves” with their employer. Other people assume that if the claim is denied, the insurance company must be correct and there is no claim to pursue. Or, it might just seem easier to let your health insurance company pay the medical bills and continue to work in pain every day.

None of these are good options if you were hurt on the job. Choosing to walk away from a potential work injury claim is simply a bad idea. It benefits the insurance company by saving them money. It hurts you if you have a legitimate claim which should be paid by workers compensation, not only now, but if you continue to have problems down the road with your current or a new employer. It only gets more difficult to prove a claim the longer you wait.

At the very least, it’s a good idea to consult with an attorney to see if you have a claim. Once an employees claim has been denied often they are intimidated by the insurance company or afraid to fight back. Or, they are afraid hiring a lawyer will cost them a lot of money. Sometimes my honest opinion is that there is no claim. More often than not, however, people I speak with have legitimate claims which are definitely worth pursuing.

The insurance company has lawyers and experienced claims adjusters handling their cases and they are aware many of the denied claims are legitimate but the people will not pursue them. Chalk another victory up to the insurance company.