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Workers’ compensation claims and denials

On Behalf of | Aug 13, 2021 | Workers' Comp |

When an employee is injured in the workplace, he or she may be entitled to workers’ compensation benefits. It’s important for the employee to receive medical attention if necessary and report the injury or illness to his or her employer. Then, he or she can submit a claim.

Claim and benefits

The employer must provide the employee with a claim form or mail it to him or her within one day of the injury or illness notification. Once the employee completes the form, it’s helpful for him or her to make a copy of it. The employee must return the form to the employer.

In California, workers are entitled to several benefits. These include medical care paid for by the employer, temporary or permanent disability benefits, job displacement benefits to help employees participate in retraining and death benefits payable to the worker’s dependents if he or she passes away from the job-related illness or injury.

Denials

If the employee’s claim is denied, he or she is entitled to dispute it. A judge can review the claim with the employee, the claims administrator and their respective attorneys. Usually, the court will try to facilitate a settlement between the parties.

The settlement may include disability payments, either paid in a lump sum or periodically, and payments for medical care.

However, if the parties cannot reach an agreement, the judge can schedule a trial where the employee can provide supporting documents and present witnesses. After the trial, the judge will make a decision in writing and notify the employee about the outcome by mail.

An experienced attorney can help workers navigate the workers’ compensation claims process and provide advice.