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When do you need an Orange County workers’ comp lawyer?
March 24, 2022 at 4:00 AM
X-ray of a shoulder injury.

Getting injured at work is no small issue. Regardless of the exact nature of the injury, it’s a situation that can take you out of the workplace for an extended period of time and cause you to miss out on days, weeks, or in some cases, potentially even months of pay. That’s why it’s crucial that you file for workers’ comp as soon as possible after you’ve received your injury.

But it isn’t always as easy as just filing at the right time to receive the compensation you need while you’re away from work. Sometimes, you may find that your claim is denied by your employer for any number of reasons. When that happens, you need to take quick, decisive action to correct the situation to the best of your ability. There are a few different steps you can take to do that, but no matter how you go about it, you should do it with the help of an attorney.

In this blog post, we’ll provide a starting point for you to explore your options when it comes to fighting a workers’ comp claim denial and better understand which of these situations may call for you to consult or retain the services of an attorney.

Why you may have been denied

There are quite a few reasons your workers’ comp claim may have been denied. Often, this can occur as a result of waiting too long after your injury has taken place to notify your employer of the incident or file your claim. These steps need to be taken immediately after the injury has taken place and you’ve received initial medical attention for it.

In California, you need to notify your employer of the injury within 30 days to minimize your risk of claim denial as a result of missed deadlines. Though the deadline for filing a claim varies between states, you should generally file within one year of the incident.

Of course, other factors may cause your claim to be denied even if you’ve met the deadlines for your employer and state. Some of these factors include:

  • Your employer disputes your claim
  • Your medical records and incident report aren’t consistent
  • The injury isn’t covered under workers’ comp insurance
  • The injury didn’t occur as you were working or within the workplace
  • You did not take steps to get medical treatment from a doctor approved by your employer and insurer
  • You quit or were fired before the incident took place
  • No one witnessed the incident
  • The injury took place while you were under the influence of drugs or alcohol
  • The injury was the result of a practical joke, fight, or other reckless act in which you participated

What you can do about it

Fortunately, even if your workers’ comp claim is initially denied, there are steps you can take to reverse the decision. Once again, meeting deadlines will be critical here. The denial letter you receive should provide a deadline by which you can file an appeal. If your appeal succeeds, the initial decision to deny you compensation could be overturned.

In addition to filing an appeal, you can take the following additional steps to get the compensation you need after your injury:

  • Keep all documentation related to the incident organized in an individual folder
  • Contact the claims examiner directly for additional information
  • Begin mediation with the insurance company
  • Bring your case before an administrative judge for a hearing

injured painful hand with bandage and medical pills on hand

Working with a lawyer

No matter how you plan to tackle your claim denial, you should do it with the help of an experienced attorney. At Mishra X Trial Lawyers, we have the experience and legal expertise to give you the best chance possible at a successful appeal after a denied claim. Contact our expert team of Orange County workers’ comp lawyers now, call directly at (949) 343-9735, or email us at am@mishrax.com.