Compensation Denial

If you've been injured in California and your workers' compensation claim has been denied, you can appeal or resolve the denial through other means, such as mediation or litigation. Fiore Legal is here to help you navigate the complex workers' compensation system and fight for the benefits you deserve.

Fiore Legal Experienced Compensation Denial Attorneys

If your workers' compensation claim has been denied in California, Fiore Legal's experienced attorneys can help you get the maximum benefits you deserve. We will investigate and evaluate your case, prepare strong medical evidence to support your claim and pursue an appeal against the compensation denial. Our team has extensive experience representing clients in similar situations, and we understand the complexities of the workers' compensation system and the tactics insurance companies use to deny or minimize claims.

Whether through negotiation, mediation, or litigation, we will work tirelessly to ensure you receive the compensation you are entitled to. Contact us today to schedule a consultation and learn how we can help you with your workers' compensation denial case.

distressed looking woman sitting on a couch with her arm in a sling while looking at a laptop

Reasons for Workers’ Compensation Denial in California

These are a few of the most common reasons for denying a workers’ compensation claim:

Failure to meet filing or reporting deadlines
Unwitnessed injury
Conflict between initial medical records and accident reports
Filing a claim after getting terminated
Failure to seek proper medical treatment
Refusal to make a recorded statement
Existing evidence of recklessness or negligence
Failing or refusing to take the required drug or alcohol test
Inaccurate or inadequate paperwork
Suspected fraud
Your illness or injury is related to a pre-existing condition

Appealing a Denied Workers' Compensation Claim in California

Appealing a denied workers' compensation claim in California can be complex. Injured workers must follow legal procedures carefully, as even a tiny mistake can result in denying their claim. That's why contacting a qualified workers' compensation attorney as soon as possible is essential to guide you through the appeals process. In addition to seeking legal help, there are other steps you can take to increase your chances of success when appealing a denied compensation claim in California:

1. File the correct petition

Injured employees who are denied workers’ compensation benefits are typically permitted to appeal the decision if:

There is new evidence
There was fraudulent activity involved in the denial process
The evidence doesn’t support the decision
The decision will cause great harm

There are two ways of appealing a denied workers’ compensation claim:

Petition for reconsideration: This appeal is filed with the Workers’ Compensation Appeals Board (WCAB) requesting a review of the decision made by the insurance carrier or claim’s administrator. A petition for reconsideration needs to be filed within a year of the date of the denial. The WCAB will then review the evidence presented before they make a decision.
Petition for removal: You may file a petition with the WCAB to request a case to be removed from the jurisdiction of the insurance carrier or the claims administrator. Instead, the claim will be seen by an administrative law judge (ALJ). You must file this petition within 20 days of receiving the denial notice. The ALJ will review all evidence and make a decision based on the evidence.

Strict deadlines apply to both petitions, making it essential to act quickly. You should also consult an attorney to determine the most appropriate petition for reconsideration and removal. Filing the wrong petition may result in a swift dismissal of your claim.

2. Appear before a judge

The next step is to attend the hearing before a Workers' Compensation Appeals Board judge. The dedicated and competent workers' compensation attorneys at Fiore Legal will present a strong case before the judge. Our attorneys will provide the evidence and testimony necessary to support your claim.

3. Wait for the decision

After hearing your request, the Workers’ Compensation Board will grant or deny your claim. Don’t despair if your appeal is denied; you may be eligible to file a Writ of Review with the California Court of Appeals. Our attorneys will present a strong case and ask for a second review to ascertain whether the denial was reached without sufficient evidence or if it was unjustified.

Our California Workers' Compensation Attorneys are Ready to Fight for Your Rights

At Fiore Legal, we are passionate about advocating for workers' rights in California. We understand how challenging it can be to navigate the workers' compensation system after a workplace injury, and we are here to help you every step of the way. Our team of experienced and dedicated attorneys has the legal knowledge and resources needed to succeed in even the most complex workers' compensation cases and appeals. We are committed to ensuring that you receive the compensation you deserve. To get started, we offer a free case evaluation. You can reach us by phone at 800-440-4157 or online.