Why hire an attorney when you need workers’ compensation

Workers’ compensation is intended to assist employees injured on the job. However, the process of obtaining benefits may be difficult.

Workers' compensation can provide essential benefits to California residents who suffer injuries or illnesses related to their employment. It can help to pay for necessary medical treatments or some lost wages. Navigating the workers' compensation process can sometimes be complicated. Working with a lawyer is a way to get proper help when filing for these benefits.

Claims not always approved

Even when a situation seems straightforward to the person who is sick or injured, a claim for workers' compensation may still be denied. PayScale explains this can happen in cases where:

  • A prior medical condition exists.
  • An injury or illness report was not filed on time.
  • A worker went to a physician who is not an authorized provider.
  • An injury or illness is determined not be related to work.
  • Inaccurate or incomplete information was given to a doctor.

When the physician does not have sufficient details, a subsequent issue may be denied coverage even if a current issue is covered. An experienced attorney can provide guidance on what information should be shared with whom and when.

Options for handling claims denials

The California Department of Industrial Relations notes that a claim denial can be contested. This process may require special medical evaluations or reviews depending upon the circumstances.

These matters are ultimately brought before a Workers' Compensation Administrative Law Judge at a Mandatory Settlement Conference. If this fails to resolve the issue, a trial will take place. If the trial upholds the original claim denial, a Petition for Reconsideration can be filed.

Reconsideration requests are handled by a seven-member appeals board. Board members have all been appointed by the Governor and received confirmation from the Senate.

Reasons others seek legal help with workers' compensation

According to the Claims Journal, some people choose to seek help from a lawyer with workers' compensation filings out of fear of retaliation. Some employees may feel that the possibility of being fired for filing a claim exists and legal involvement may give them a better sense of protection.

In some cases, employers disagree with employees about the legitimacy of a claim and this may lead to claim denials. People in these situations have relied upon legal input for help.

Lawyers experienced with workers' compensation know how to make sure all forms are completed accurately and on time. Sometimes it can be these things that make the difference between an approval and a denial of a claim. It is equally beneficial to have someone on the workers' side if a claim is denied. Anyone in need of workers' compensation benefits in California should contact an attorney to discuss these and other issues.