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Workers' Compensation Denial Lawyers in Fremont, CA

Fight Back Against Unfair Workers' Comp Denials

When you're injured on the job in Fremont, workers' compensation benefits are your lifeline, helping you to heal without the stress of financial strain. Unfortunately, it's not uncommon for workers' comp claims to be unjustly denied. If you're facing this challenge, don't lose hope. Pacific Workers' is your dedicated advocate.

Our team specializes in overturning workers' compensation denials, providing you with the expert guidance and representation you need. An appeal could be your opportunity to secure the benefits you're entitled to. We're here to assess your situation and navigate the best course of action.

For insight into workers' comp denials in Fremont, call us at (888) 740-6434 today.

Common Grounds for Workers' Comp Denials

Workers' compensation claims can be denied for various reasons, such as the following:

  • Failure to report the injury promptly: If an employee does not report the injury within the specified timeframe required by the employer or the workers' compensation board, the claim might be denied.
  • Lack of medical evidence: Insufficient medical documentation or evidence supporting the claim can lead to denial. This may include incomplete medical records, inadequate documentation of the injury, or a lack of evidence linking the injury to the workplace.
  • Pre-existing condition: If the injury is determined to be related to a pre-existing condition rather than a workplace accident or occupational exposure, the claim might be denied.
  • Misconduct or violation of company policies: If the injury occurred while the employee was violating company policies, engaging in illegal activities, or under the influence of drugs or alcohol, the claim may be denied.
  • Failure to seek timely medical treatment: Delay in seeking medical treatment after the injury occurs can raise doubts about the severity or validity of the claim, leading to denial.
  • Disputes over the cause of the injury: If there is a disagreement between the employer, insurance company, and employee regarding the cause of the injury or whether it occurred during the course of employment, the claim may be denied pending further investigation or legal proceedings.
  • Statute of limitations: Failing to file the workers' compensation claim within the statute of limitations set by law can result in denial.
  • Failure to follow prescribed treatment: If the injured worker does not comply with the prescribed medical treatment plan or fails to attend medical appointments, the claim may be denied.
  • Independent medical examination (IME) findings: If an independent medical examination commissioned by the insurer disputes the severity or nature of the injury, it can lead to denial of the claim.
  • Administrative errors: Simple administrative errors such as incomplete paperwork, missing documentation, or inaccuracies in the claim form can result in denial.

Challenging a Denied Claim

Challenging a denial of a workers' compensation claim typically involves following specific procedures and may require legal assistance. Here are some common ways to challenge a denial of a workers' comp claim:

  1. Review the denial letter: Carefully review the denial letter provided by the insurance company or employer. It should outline the reasons for the denial and any specific steps you need to take to appeal the decision.
  2. Gather additional evidence: If the denial is due to lack of sufficient medical evidence or documentation, gather any additional medical records, test results, or witness statements that support your claim. This may involve obtaining a second medical opinion or consulting with specialists.
  3. File an appeal: Most workers' compensation systems have a formal appeals process. Follow the instructions provided in the denial letter to submit an appeal within the specified timeframe. Make sure to include all relevant documentation and evidence supporting your claim.
  4. Request a hearing: In some cases, a hearing before an administrative law judge or workers' compensation board may be necessary to resolve the dispute. During the hearing, you will have the opportunity to present your case, provide evidence, and testify under oath. It's advisable to have legal representation at the hearing to ensure your rights are protected.
  5. Mediation or settlement negotiations: In certain jurisdictions, mediation or settlement negotiations may be available as an alternative to a formal hearing. This involves meeting with a neutral third party to try to reach a resolution outside of court. An attorney can help you negotiate a fair settlement that covers your medical expenses and lost wages.
  6. File a lawsuit: If all other options for resolving the dispute are exhausted, you may choose to file a lawsuit against your employer or the insurance company in civil court. This is typically a last resort and should be done with the guidance of an experienced workers' compensation attorney.
  7. Seek legal representation: Workers' compensation laws can be complex, and navigating the appeals process can be challenging. Consider hiring an attorney who specializes in workers' compensation claims to represent your interests and guide you through the process. An attorney can provide valuable advice, advocate on your behalf, and ensure that your rights are protected at every stage of the appeal.

We're Here to Help

Pacific Workers', The Lawyers for Injured Workers, is committed to supporting Fremont's workforce across all sectors. If your workers' comp claim was denied for any reason, we're determined to find a solution. Partner with us to explore your options.

If you've been denied workers' comp benefits in Fremont, reach out to us at (888) 740-6434.



    Thank you for being so kind and completely sympathetic to my case!

    “I started my fight against my company's workers comp and after talking to Almarie for the first time I already felt a lot of weight off my shoulders. It feels nice to have someone fighting for your rights but also keeping you in check for your own good.”

    Jazzie D. Daly City, CA
    They took care of me!

    “Bilal worked on my case and he was very professional, friendly, and kind to me. I was so nervous about my deposition and he made me feel very comfortable and less stressed about the whole situation.”

    Gabi O. Sacramento, CA
    The most down to earth team I have ever met!

    “They have strong communication and I was respected throughout the whole process. They had never given up on me!”

    Nekealla C. Tracy, CA
    I'm forever grateful & thankful to all!

    “I especially want to thank Mr. Jason Insdorf, who worked in attaining a settlement I never expected.”

    L.S. Union City, CA

Workers' Comp FAQ

  • Am I Eligible for Workers’ Compensation?

    In California, all employees are eligible for workers’ compensation with very few exceptions. If you are classified as an “employee” (rather than an “independent contractor”), you are eligible to receive benefits. This is true regardless of how many employees your employer has, how many hours you work, how much you make, whether you work part-time or full-time, or whether you are a seasonal worker. Additionally, undocumented workers are also eligible for workers’ compensation granted they meet all other eligibility requirements. In contrast, independent contractors and certain other workers, including some volunteers, household workers who are employed by a family member, and others, are not able to file for workers’ compensation benefits.

  • Can't I Just File for Workers' Compensation on My Own?

    Filing for workers' compensation on your own increases the chances that your claim will be denied. One small misstep can prevent you from obtaining the compensation you need for your injuries. In addition, the process is usually complex and tedious, especially for someone with no workers' compensation law experience. It is extremely advantageous that you seek reliable and experienced legal guidance for your claim.

  • What Can I Expect from the Workers' Compensation Process?

    As soon as you reach out to us for help, we will assign you a full-time case manager and attorney. An application will be filed with the Workers' Compensation Appeals Board (WCAB) on your behalf. We will get started on your case immediately to help you receive the medical care you need. If we are unable to receive a fair settlement from the insurance company, we are ready and willing to take your case to trial. After a few months, you will most likely give a deposition. One of our highly experienced attorneys will prepare you and stand at your side the entire time. You don't even have to attend court hearings! One of our trained hearing officers or attorneys can attend on your behalf.

  • Can My Employer Tell Me to Use Sick Time or Vacation/Personal Time off (PTO) If I’m Injured at Work?

    Following a work-related injury, you may not receive workers’ compensation benefits right away or your workers’ compensation claim may be denied. You may receive a note from your doctor that you may take time off work due to your injuries, but how will you be paid if you are not actively seeking workers’ compensation benefits? Your employer may tell you to use your state-mandated/employer-provided sick time in order to continue being paid while you are out of work. Once this sick time is exhausted, your employer may tell you that the only way you can continue to be paid is if you use your vacation or PTO time. In some cases, this may actually be the only way to continue receiving wages while you are out of work and not receiving workers’ compensation benefits. For more information, check out our video with Attorney Bilal Kassem on this topic by visiting our Facebook page!

  • Can I Get Workers’ Compensation If I Was Fired?

    If you were terminated while already receiving workers’ compensation benefits, this does not necessarily affect your right to receive benefits. However, if you were terminated “for cause” (for example, if you were fired because you were caught stealing from your employer), you will not be able to continue collecting benefits. If you were not fired for cause, but were laid off due to your position being terminated or various other reasons, you may still be able to continue collecting your workers’ compensation benefits. If you believe you were terminated because you filed for workers’ compensation or because you were hurt at work, you may have grounds for a retaliation claim. Learn more, including whether you can continue receiving workers’ compensation benefits if you were laid off due to the coronavirus pandemic, see our video with Attorney Bilal Kassem on our Facebook page.

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