Legal Strategies for Challenging Denied Claims

If Your Claim Was Denied, Don’t Give Up

If your workers’ compensation claim was denied, you’re not alone. More importantly, a denial doesn’t necessarily mean that your claim is invalid. The insurance companies have one goal: to keep as much money as possible. For this reason, they sometimes deny valid claims in the hopes that the injured individuals will simply give up.

Don’t let them get away with it. Instead, consult a skilled workers’ compensation lawyer at Leep, Tescher, Helfman and Zanze for understanding counsel and vigorous representation. Attorney Ben Helfman is experienced in handling workers’ compensation issues in Redding, across Shasta County and throughout the surrounding areas of California. Additionally, he is a board-certified specialist, which means you can count on him for the high-quality advocacy you deserve.

Do Any Of These Excuses Sound Familiar?

Here are the most common excuses that insurance companies give for denying workers’ compensation claims:

“You don’t have enough medical evidence to prove that you are really injured.”
“Your health problems are due to pre-existing conditions. They don’t have anything to do with your job.”
“You weren’t actually in the office/factory/workplace when the injury occurred, so it doesn’t count.”
“You’re classified as an independent contractor, not an employee, so you don’t deserve benefits.”

Another factor that can lead to a denied claim is the process of selecting a QME, or qualified medical examiner. When you receive the list of medical specialties that you may choose from, it is critical to consult with an attorney to ensure your selection does not jeopardize your claim. Mr. Helfman can guide you throughout this process from start to finish, also ensuring you meet every key deadline.

It’s true that not everyone is entitled to workers’ compensation benefits, but many are. You need an attorney who will take action to uncover the truth about whether you qualify or not. Mr. Helfman won’t take your employer’s word for it or that of the insurance company.

How To Combat A Denied Injury Claim

Here are the basic steps you need to take to combat a denial:

File an Application for Adjudication of Claim at the appropriate Division of Workers’ Compensation (DWC) office. There are 24 of these offices, and each one essentially operates as a trial court to settle disputes.
The DWC office will send you a notice and assign you a case number.
To arrange a hearing before a judge, you need to file a Declaration of Readiness to Proceed. Then, a mandatory settlement conference (MSC) will be scheduled.
At the MSC, you and the claims administrator will answer the judge’s questions. If a settlement isn’t possible, the judge will schedule a trial.
If your claim is denied again at the trial, you have the option to file a Petition for Reconsideration.

These five steps can be complex, but hiring an attorney can help you ensure that your documentation is in order and you meet all relevant deadlines. Not only will an experienced lawyer help you with the legal requirements for your case, but they can also help you face this process with greater confidence.

Attorney Ben Helfman Is Here For You

If these steps sound confusing and difficult, don’t worry. That’s what the legal team at LTHZ Law is here for: to guide you through every part of the process and take the stress off your shoulders. To get the clear, legal help you need, contact the Redding office to set up a free consultation today. Call the firm at (530) 287-6674 or reach out online.