Can I Appeal a California Workers’ Compensation Decision?

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Can I Appeal a California Workers’ Compensation Decision?

man in safety equipment at job

When you go to work, the last thing you expect is to sustain an injury while fulfilling your job duties. Unfortunately, this is far too common for many workers, leaving them out of work and suffering astronomical medical bills. As such, you may submit a workers’ compensation claim to help cover your expenses. However, if this is denied, you may not know how to proceed. You’ll want to read on to learn more about why your claim may have been denied and how a Sacramento personal injury lawyer can assist you if you choose to file an appeal to recover the compensation you deserve.

What Is Workers’ Compensation?

Workers’ compensation is a form of insurance that employers carry to help cover expenses for employees who sustain injuries or fall ill while on the job. All employers must provide these benefits to their employees, with very few exemption exceptions. Coverage includes compensation for medical expenses, temporary and permanent disabilities, death benefits, and displacement vouchers, which help cover the cost of training and education for those who cannot return to their original duties.

It’s important to understand there are situations where workers’ compensation would likely be denied. For example, if the injury occurred while you were engaged in horseplay or roughhousing, you were intoxicated, or you were engaged in a physical altercation with another co-worker, you would likely be denied workers’ compensation.

Why Might I Need to Appeal the Decision?

In some instances, you may find that your claim has been denied, even though you know you are entitled to the funds. Commonly, you may find that denial can occur if you failed to report the injury in a timely manner, did not seek medical treatment, saw a doctor who was not approved by your employer, your employer disputed the claim, or made errors when filing the claim.

If you know you took the appropriate actions after sustaining the injury, the denial is likely caused by your employer disputing the claim or an error during the filing process. Your employer may try to say your injury occurred while you were off the clock to avoid facing higher premiums because a claim was filed. Similarly, you may have incorrectly filled out the form or forgotten to submit additional information.

If you need to appeal the decision, contact an attorney to walk you through this process. Unfortunately, trying to navigate this on your own can be complex, as there are many things you must take into consideration. Luckily, the Law Offices of Dale R. Gomes can assist. We understand how devastating injuries sustained at work can be. As such, we will do everything possible to help you navigate these situations. Contact us today to learn how we can help you.