lify a Preexisting Injury
My Claim Was Denied
Now What?
also has to happen either at work or because of workplace duties. However, the definition of “workplace” is almost anything
work-related. This can mean that you’re equally as covered if you slip on the way to the bathroom as you would be if you get into an accident while you’re running errands for your boss.
It can be the worst feeling in the world: You got hurt at work, made sure to dot the i’s and cross the t’s when you filed your DWC-1 form, then took some much needed time to recover, only to be turned down by the insurance company. Receiving notice that your claim was denied — when your injury happened at work and you know the pain is real — can be frustrating, disheartening, or downright terrifying. Thankfully, this denial letter isn’t the end of the road. Keep Treating Your Injuries Medical bills can be difficult to keep up with without the aid of workers’ compensation, but it’s important that you do everything you can to address your injuries. This means sticking to prescribed medication regimens and going to follow-up visits with doctors and therapists. Failing to do so can hurt you in two ways: Your injury may get worse, and you are giving the insurance agency more ammunition to poke holes in your claim. Who Can You Call? Don’t let a denied claim cast doubt on your injuries. Insurance companies deny valid claims all the time, knowing that most workers won’t fight back. But an experienced California workers’ compensation attorney can guide you through the complex legal process to force the insurers to accept your right to compensation. Workers’ Compensation Appeals Board Qualified Medical Evaluator and Agreed Medical Evaluator The next steps illustrate the need for an experienced lawyer. Depending on the reasons your claim was denied, different legal approaches will be required. If the insurance company disputed some crucial fact to your case, such as whether you’re an employee, you’ll need to have a hearing before the Workers’ Compensation Appeals Board (WCAB). If the cause of your injury is what’s in question, you will need to see a qualified medical evaluator (QME) or an agreed medical evaluator (AME) to evaluate your claim. This is just a brief overview of what is a challenging, but not impossible, process. You don’t have to give up your compensation based on a single denial. Call an attorney and fight for your rights.
You’re not covered if you’re found to have caused the injury to yourself, or you injured
yourself while intoxicated, committing a crime, or in a fight where you were the first aggressor. The good news to all these parameters is that if you’re injured at work and eligible for workers’ comp, your previous injury does not play a factor! We will work hard to provide evidence that the aggravation of your preexisting injury had something to do with the conditions of your workplace and we will do whatever we can to get you access to all the benefits that California Workers’ Compensation has to offer. To find out more about how we can help, visit our website at PacificWorkers.com.
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