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Why Was My Workers' Comp Denied?

Whether you suffer an injury at the workplace in a traumatic accident or occupational disease (such as carpal tunnel syndrome), you are most likely eligible for a workers’ compensation claim in California. Unfortunately, workers’ compensation claims may be denied for multiple reasons, such as failing to meet the eligibility requirements or making a mistake on the application.

If your workers’ comp claim is denied, you will receive a denial letter. The letter will likely address the reasons your claim was denied.

The following are the most common reasons for workers’ compensation claim denial:

  • The injury was not reported in a timely manner - State laws determine the amount of time you have to report an injury to your employer. In California, you have only 30 days to report the claim.
  • Your injury did not occur at work - In order to be eligible for workers’ compensation benefits, your injury must have happened during the course of your job duties. So if you suffered an injury on your break, at lunch, or during your morning commute, you’re most likely not eligible to file a claim.
  • You failed to receive medical treatment - If you do not seek immediate medical treatment, but then later attempt to file a workers’ compensation claim, the insurance carrier may deny your claim that doesn’t have supporting medical records. Seeing a doctor right after an accident can ensure a successful claim.
  • Your employer disputes your claim - Employers may be afraid that the cost of their workers’ compensation coverage will increase if there is a claim on their policy. They could argue that the details of the case are inaccurate or that you were not at work during the time of your injury. If there are no witnesses or surveillance footage to support your claim, your employer can successfully argue against your claim.

It is critical to get in contact with an experienced lawyer. Our Orange County workers’ comp attorneys at Alvandi Law Group know exactly how to deal with denied claims, even if your employer is trying to dispute your case.

Schedule a free consultation and let us protect your rights and best interests today.