Workers’ Compensation Denials in Stockton
Was Your Claim Denied? Call Our Lawyers
If you or a loved one has suffered an injury or illness at work that may be covered by California's workers' compensation laws, Pacific Workers', The Lawyers for Injured Workers in Stockton can help, even if your claim was denied. Our experienced attorneys understand how to navigate the often-complex process of filing for workers' comp benefits, which only gets even more complicated once a denial has been issued. Do not miss your opportunity to pursue the benefits and compensation that you deserve. Take action today by reaching out to our firm.
For a free initial consultation, just dial at any time.
Reasons for Workers’ Comp Denials
When a workers’ compensation claim is denied, don’t assume that the case is over. Even if the case is denied for legitimate reasons, there might be a possibility to reverse the denial or challenge it in court if necessary.
To begin a workers’ compensation denial case, our attorneys will want to review the denial letter that should have been sent to you as soon as possible once the denial was processed. Using this letter, we can see if the denial is factually incorrect, or if there is another reason why it might not be correct based on the specifics of your case.
Examples of common reasons for a workers’ compensation claim denial are:
- You Missed The Deadline: The statute of limitations for Workers’ Comp is 1 year from the date of your injury or the last time you were treated by a Workers’ Compensation doctor. Sometimes, injured workers aren’t aware of this, and you might not know you have to file the claim within 1 year. This can hurt your claim. You should also understand that once the insurance company receives the claim, they will have up to 90 days to investigate the claim. Within those 90 days you are entitled for up to $10,000 in medical benefits.
- Not Having Evidence: The insurance company needs to know what happened, and they want to see some proof that you were injured while on the job. Many injured workers don't have the evidence they need to succeed in getting their claim approved and this can be used against them. If this is your case, seek for legal help as soon as possible.
- Other reasons: The injury happened in a non-work-related accident, the injury did not require medical attention or time off work, or the accident was never reported to the employer.
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Communication is extremely important, and that has been A+ since the beginning!
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How to Challenge a Denied Claim
When our Stockton workers’ compensation denial attorneys spot a reason to challenge a denial, we can next work on our strategy to challenge it. By using an Application for Adjudication of Claim and a Declaration of Readiness to Proceed, we can begin the process to challenge the denial and bring the case before a judge. If the judge’s decision is not in your favor or we expect the opposition to oppose a ruling in your favor, you don’t have to worry. We will be ready to take the case to trial after the hearing.
After the trial or hearing, if it ends in your favor:
- Your workers’ compensation benefits can be instated; or,
- You could be provided a settlement that pays for the benefits you should have been given, as well as other losses that might have occurred due to the denial.
We cannot guarantee or promise one outcome or another. However, when you are our client, we can say that we use our full range of talents and experience to do the most for your case, so it gets a fair chance in and out of court.
Do you think that you might be a misclassified employee who needs workers’ compensation benefits after an incorrect claim denial? We want to hear from you. Call today.
Are You an Independent Contractor?
In California, most independent contractors are not covered by workers’ compensation insurance. However, we have also seen cases in which someone was incorrectly classified as an independent contractor when they were performing the work of an employee. If you were incorrectly classified and injured at work or in a work-related accident, then you could still be eligible for workers’ compensation coverage as an employment benefit.
Under California’s “ABC test” for employment status, you are an employee unless the employer can prove that:
- You are free from the control and direction of the employer related to work performance and procedures;
- You perform work that is outside the usual course of the employer’s business; and,
- You are “customarily engaged” in an independently established trade, occupation, or business that is the same as the employer’s.
We are Standing By – Contact Our Firm
Our Stockton workers’ comp case denial lawyers are dedicated to fighting for the rights of injured workers in all industries. If your claim has been denied for any reason, please act quickly. Dial to request a no-obligation case evaluation, so we can see if you could have a chance to challenge the denial.
Workers' Comp FAQ
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Are Independent Contractors Eligible for Workers’ Compensation Benefits?
Independent contractors are generally not eligible for workers' compensation benefits because they are not considered employees under California law. However, some employers may misclassify employees as independent contractors. If you believe you are misclassified, consult with a legal professional to assess your situation.
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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.
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Are There Other Benefits I Can Receive If I’m Unable to Work During the Off-Season Because of an Injury?
If you're unable to work during the off-season because of a work-related injury, you may be eligible for additional benefits, such as those provided by the Employment Development Department (EDD). It's important to explore all available resources to support yourself during your recovery.
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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.
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How Long Do I Have to File a Workers’ Compensation Claim?
In California, you generally have one year from the date of your injury to file a workers’ compensation claim. However, you should report the injury to your employer within 30 days to avoid complications.
