Workers’ Comp is a no-fault system, which means that if you are injured at your workplace in the State of California, you will most likely receive benefits unlike in personal injury cases. such as car accidents, where fault must be proven. In work injuries, you do not have to prove that your employer acted negligently in order for the insurance company to award you compensation. That said, you may still receive a denial notice for WC (Workers’ Comp) benefits. If you receive it, you will surely wonder why?
Here are some of the most common reasons for denial of worker’s compensation benefits.
Not submitting your report in a timely manner. If you did not report your injury within the time frame specified by California State law, you may have lost your rights to workers’ compensation benefits. Although state laws vary, you generally have between 30 and 90 days to file your claim.
Failure to report your injury to your employer or supervisor in writing, no later than the next day.
Occasionally the insurance company will deny a workers’ compensation claim because the employer disputes it. For example, your employer may claim that your accident occurred off the job, or that you were messing around with another employee.
Another reason the insurance company may have denied your claim is that your injury is not compensable.
For example, stress-related injuries in the State of California are not compensable. However, they can occur, mainly victims of traumatic, violent or frightening events.
The insurance company may also have denied your workers’ compensation claim if you did not receive medical treatment after the accident. In almost all workers’ compensation cases, the insurance company requires proof of injury.
Ultimately, the insurance company may have denied your claim if you did not provide sufficient evidence that your injury was work-related. A complete medical exam and some additional evidence can help establish your work origin and support your claim.
If you were injured at work and are in any of these cases, it is very likely that you will need legal advice or representation to obtain the benefits to which you are entitled, so it is advisable to contact a lawyer dedicated to compensation cases. to the worker (Workers’ Comp). This article is not intended to serve as legal advice. It is for informational purposes only.