California workplace accidents are always stressful, but what if your medical benefits are denied? Sadly, this is a common problem among the state’s hardworking employees.
Below, we explain why medical benefits may be denied and how you can find relief in the worst-case scenario.
Why Are California Workers’ Comp Benefits Denied?
A variety of issues can lead to workers’ comp denials in California. These denials generally arrive because the responsible claims administrators believe that your injuries are not covered according to local workers’ comp protocol.
Key issues that contribute to this conclusion include:
- Offsite injuries. Where, exactly, did the workplace accident take place? It may seem evident that the incident was related to your work duties, but administrators can and will try to argue that the issues occurred offsite.
- Preexisting conditions. Even if your accident occurred at work, your claim could be denied if the administrator believes that a preexisting condition caused the injury.
- Severity. Injuries that appear minor can prove devastating from your perspective. Unfortunately, claim denials often arrive when injuries are deemed not severe enough to warrant coverage.
- Proof of treatment. To be eligible for workers’ comp claims, you must prove that you sought medical treatment following your injury.
What to Do After Your Medical Benefits Are Denied in California
Given the complications of workers’ comps claims in California, it always behooves you to have a trusted attorney in your corner from the get-go. If your claim has already been denied, it’s not too late to get a lawyer involved. Find an attorney with a strong background in workers’ comp.
This will give you the best possible chance of securing medical benefits.
If you suspect that, despite your denial, you are eligible for workers’ comp benefits, you can begin by filing a formal claim with the California Division of Workers’ Compensation. Time is of the essence; wait too long to respond, and you may be denied the chance to appeal your case.
As you proceed, you’ll need to file a request to have your case heard before an administrative law judge. Both you and your attorney should be present for this hearing. Known as the mandatory settlement conference (MSC), this will involve an effort to settle before going to trial. Settlements are not required, but you and your lawyer must make a good-faith effort to resolve your case.
Depending on your situation, the MSC may eventually be followed by a trial and a writ of review. Again, assertive legal representation will prove beneficial.
Take Action With the Law Offices of Hussain & Gutierrez
If your workers’ comp benefits have been denied, you must take action as soon as possible. Thankfully, you don’t need to go it alone. With a Van Nuys workers’ compensation lawyer on your side, you can feel confident in your prospects for securing medical benefits.
Our team at the Law Offices of Hussain & Gutierrez can guide you every step of the way. Empathetic yet proactive, we have what it takes to bring your workers’ comp case to a good close. To take the next step, get in touch so we can discuss your legal concerns.