Employees in California might seek out workers’ compensation benefits in a variety of different scenarios. Sometimes, they might need benefits after a sudden injury caused by a specific incident. Other times, they may have a job-acquired health condition. Illnesses and cumulative trauma can lead to workers’ compensation claims in California.
Frequently, workers benefit from a relatively straightforward claims process. There’s little question about the origins of their condition, its impact on their health and what treatment they require. They can receive the medical coverage and disability pay they deserve.
Other times, they may find themselves facing an uphill battle. Their employer may dispute the origins of their injury. The doctor they see initially may not listen to their symptom complaints. Some employees face denied benefits claims when they need medical care or can’t work.
How can employees handle denied workers’ compensation claims in California?
Employees have the right to appeal
As a general rule, there are several options available for a worker facing a complex benefits claim. They can request a reconsideration or appeal an unfavorable determination. They do this by submitting appropriate documentation to state authorities.
In cases involving a disagreement with an employer, they may need to undergo a special medical evaluation performed by a licensed medical professional chosen from a panel of options. A review can establish the impact of the condition and help pinpoint the likely origin of the malady as well.
In more extreme cases where the dispute isn’t easy to resolve, disagreements about workers’ compensation can sometimes involve requesting review by the Division of Industrial Relations Workers’ Compensation Appeals Board.
Appeals may require outside support
The appeals process can be even more complicated than the initial application process. Particularly when employees have struggled with the early stages of the benefits process, they may need the assistance of a legal professional.
Attorneys familiar with the rules for workers’ compensation in California can help employees with the complicated appeals process. From educating their client about their rights to handling paperwork on their behalf, there’s much that a lawyer can do to assist an individual with a complex workers’ compensation claim.
Having the right assistance can make all the difference for those struggling to obtain workers’ compensation benefits. Employees appealing on favorable determinations can sometimes get the medical and disability benefits they require.