Laborers, nursing assistants, registered nurses, retail salespeople, janitors, and light truck drivers are among the top ten occupations to experience workplace injuries or illnesses. Whether you work in one of these positions or another one, you have the right to workers’ compensation benefits if you become injured on the job or suffer a work-related illness.
However, many employees don’t receive the benefits they deserve. Insurance companies have a tendency to deny claims unfairly to increase their profits, leaving injured or ill employees and their families to fend for themselves. Suppose your workers’ compensation claim has been denied, or you feel you aren’t getting the benefits you deserve. In that case, it’s time to contact the experienced Los Angeles workers’ compensation attorneys at the Arshakyan Law Firm.
Workers’ comp benefits are designed to financially support injured workers and help them return to their job duties. California workers’ compensation benefits include:
- Medical treatment for the work-related injury
- Lost wages referred to as temporary disability benefits
- Permanent loss of function referred to as permanent disability benefits
- Job displacement benefits such as retraining
Each one of these benefits is necessary to help an employee afford their injury expenses, keep their family afloat financially, and get back to work in some capacity.
To be eligible for California workers’ compensation, you must file a workers compensation claim form. Once the insurance company receives the form, they will investigate the claim and make a determination of coverage. You will then receive a letter from the insurance company regarding their decision.
If the insurance company denies your benefits, you can file an Application for Adjudication of Claim, request a Mandatory Settlement Conference, and then a trial. It’s imperative to have experienced Los Angeles workers’ compensation lawyers on your side during this process. They know the rules and procedures and can help guide and advocate for you.
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Your employer or their insurance company can deny workers’ comp benefits for many reasons. Some might apply to your individual claim, and some might not. Here are a few common denial reasons.
You Don’t Have a Work-Related Injury
Your injury must have occurred during the course and scope of your employment, and it must arise out of your employment. If your injury occurred while you were on a break or you can’t prove that your work duties were more than 50 percent to blame for your injuries, your claim will likely be denied. However, worker’s comp also applies if you suffered a workplace-related illness or were driving in the course of your job duties and were in a car accident.
Your Injury or Illness Isn’t Covered
Workers’ comp is an insurance policy that isn’t government-funded. Similar to an auto or homeowner’s policy, certain conditions or circumstances might not be covered. For instance, mental health isn’t generally covered by workers’ comp. Even if a stressful work environment caused your depression or anxiety, it’s unlikely that your workers’ comp claim covers psychiatric care.
You Didn’t Report Your Injury Before the Deadline
After a workplace injury, you only have 30 days to file a workers’ comp claim. If you don’t notify your employer or the insurance company with that timeframe, your claim will probably be denied.
A significant increase in workers’ comp fraud has caused insurance companies to be suspicious of workers’ comp claims, especially under certain circumstances. If you wait too long to file a claim, it looks like you weren’t hurt or weren’t hurt as seriously as you claim to be. If you file a claim after being laid off or fired, it can look even worse and as if you are seeking revenge.
You Have a Pre-Existing Condition
Perhaps you told your employer that you had scoliosis when you first started working. They gave you all the required gear to prevent injury, but you still pulled your back out. The next thing you know, your workers’ comp claim is denied because your back injury was a “pre-existing condition.”
Although these types of claim denials frequently occur, this isn’t a cause for a claim denial. If a workplace accident makes a pre-existing injury worse, you still deserve compensation and other benefits.
How Los Angeles Workers’ Compensation Attorneys Can Help
Los Angeles workers’ compensation lawyers can be an invaluable asset to you at every step in the workers’ comp process. They can:
- Help you complete paperwork
- Ensure your claim is filed on time
- Gather medical and vocational evidence to support your claim
- Obtain medical opinions from your treating physicians
- Investigate how unsafe work conditions or practices might have lead to your injury
- Represent you during any depositions you might need to attend · Depose medical experts
- Negotiate and structure a settlement agreement
- Represent you at a workers’ comp hearing or trial
- Look for potential third-party claims and other benefits you could receive—you may be able to file a personal injury claim against other parties who caused your injury
Los Angeles workers’ compensation attorneys are familiar with the tactics many employers and their insurance companies attempt to use to delay or deny your claim. They can face these tactics head-on to help get you the benefits you deserve. Your lawyer will also keep you informed about your claim and explain every part of the process. If your claim is denied and you need to file an appeal, they can help with that too.