Tracy Workers’ Compensation Appeals Attorney

Why Appeal a Denied Workers’ Compensation Claim?

Although it may seem easier to start over—or hopeless to fight back—when your workers’ compensation claim is denied, there are numerous reasons to appeal. According to data from Lockton, the world’s largest independent insurance brokerage, almost 70% of denied workers’ compensation claims are ultimately paid within the year. Even more surprising, the same data found that converted claims (those initially denied and ultimately paid) awarded approximately 55% higher payouts than the initial amount claimed.

Appealing a denied workers’ compensation claim isn’t just your right; it is also an opportunity to recover the benefits you rightfully deserve, and the overall likelihood of success is relatively high. However, there are no guarantees, and your chance of a successful appeal depends on numerous factors. One of these factors is the legal representation you choose.

Having the right attorneys by your side during the appeals process can make a significant difference in the outcome of your claim. You want a team that has extensive experience handling workers’ compensation claims and appeals, a team that has the resources and know-how to effectively build your case and protect your rights. At Pacific Workers', The Lawyers for Injured Workers, we have successfully helped countless clients navigate the workers’ compensation appeals process, from the initial filing stage to appearing at mandatory hearings and other related proceedings. When you choose our firm to assist you with your denied claim appeal, you can trust that we will do everything possible to recover the benefits you are owed. Our Tracy workers’ compensation appeals attorneys will be there for you every step of the way.

Common Reasons Workers’ Compensation Claims Are Denied

It is important to understand why your claim may have been denied, as this can impact your ability to appeal, as well as the appeals process.

Some of the most common reasons that workers’ compensation claims are denied include:

• Disputes over coverage/eligibility
• Accusations of employee negligence or misconduct
• Lack of medical treatment
• Lack of time off due to an injury or illness
• Failure to report the injury
• Failure to meet applicable deadlines
• Mistakes or lack of adequate information on the initial claim
• Administrative errors

Our attorneys can sit down with you to discuss your case and review your initial claim to determine why it was denied. We can then advise you as to the best course of action, including whether we believe you have grounds to appeal. There is no cost and no risk in talking to a member of our team today about your legal rights and options.

How to Appeal a Denied Workers’ Comp Claim in California

There are several steps involved in appealing a denied workers’ compensation claim in California. Here, we have provided a brief overview of the workers’ comp appeals process, but keep in mind that the exact steps you may need to take could differ depending on your unique situation. We recommend that you use this overview as a guide of what to expect and, for more detailed information regarding your circumstances, reach out to our Tracy workers’ compensation appeals lawyers for a free consultation.

The steps involved in appealing a denied workers’ compensation claim in California include:

• File an Adjudication of Claim: This application is a part of your official workers’ compensation claim and provides your case with a number. You must file your Application for the Adjudication of Claim at the Department of Workers’ Compensation (DWC) office in the county where you live or were injured (if different).
• Request a Hearing: Once your Application for Adjudication of Claim has been received, and you have been given a case number, you can request a hearing before a Workers’ Compensation Appeals Board (WCAB) judge by filing a Declaration of Readiness to Proceed. Once you have filed this form, you may be schedule for a mandatory settlement conference (MSC).
• Attend the Pre-Trial Conference: The MSC serves as a pre-trial hearing with the intended purpose or resolving the issue without having to proceed to trial. At the conference, you, your case administrator, and both your legal representatives will provide evidence in support of your respective claims to the judge. The judge will attempt to resolve the dispute through settlement.
• Prepare for Trial: If your workers’ compensation dispute cannot be resolved at the pre-trial hearing, you and your legal representation will need to prepare for trial. This typically involves putting together various documents, gathering evidence, and assisting witnesses in preparing to provide testimony.
• Attend the Trial: Your presence is required at the trial, which will be held before a different judge than the one who presided over the pre-trial conference. Once both parties have presented their sides, the judge will decide on the case and provide a written decision by mail within 30 to 90 days.
• File a Petition for Reconsideration: If you disagree with the judge’s decision, you may request a reconsideration. To do so, you will need to file a petition within 20 – 25 days of receiving the judge’s written decision. You are only allowed to request a reconsideration in certain circumstances; an attorney can help you determine if you have grounds to take this step.

Appealing a denied workers’ compensation claim in California is a complex and time-consuming process. It is extremely important that you work with a skilled legal team that knows how the system works and can protect your rights every step of the way.

Schedule a Complimentary Consultation

At Pacific Workers', The Lawyers for Injured Workers, our Tracy workers’ compensation appeals attorneys are here to fight for you and your rights. We are dedicated almost exclusively to the practice of workers’ compensation law, allowing us to devote all of our time, efforts, and resources to helping injured employees recover the fair benefits they are owed. We are well-versed in the appeals process and know how to protect your best interests every step of the way.

With over 250 four- and five-star reviews from our clients, we are the people’s choice for workers’ compensation representation in Northern California. Learn how our award-winning firm can assist you with your claim today.

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