What if my Fontana workers compensation claim has been denied?
In the California workers’ compensation system, the work comp adjuster can place your claim on delay status for up to 90 days from the date of the defendant’s receipt of your comp claim for investigation. Within this 90-day delay status period, the insurance adjuster is supposed to conduct a good faith investigation into the facts and circumstances surrounding your reported work injury. Based on adjuster’s investigation, they may accept your claim and begin or continue to authorize treatment and pay you workers’ compensation benefits. If not, the workers compensation insurance adjuster may send you a denial letter, denying your injury claim. Some body parts may be accepted, some may be denied which further complicates things since finding a doctor near Fontana in their medical provider network to treat the denied body parts can be a problem for you.
My workers’ compensation claim has been denied completely. What does this mean for you?
Frequently, the adjuster will deny your workers’ compensation claim in completely. This means they’re not going to pay you any benefits of any kind. Sometimes it’s a result of their investigation, sometimes they say it’s a lack of medical evidence. If the adjuster denies that you had a work injury arising out of your employment in the course of your job or that your claim is post termination, (means that they learned of your injury after your termination date) this will also be a basis to inform you that they don’t owe you any workers’ compensation benefits.
What do you do if your Fontana work injury claim has been denied?
If or when your workers’ compensation claim is denied, it is important that you have an experienced workers compensation doctor familiar with your type of injury and an experienced lawyer on your side. An experienced work injury lawyer near Fontana can help you fight against a full denial of liability. If the adjuster refuses to settle your case and continues to deny your Worker’s Compensation benefits, you may even need to go to court at the Workers’ Compensation Appeals Board (“WCAB”). Our office services the Pomona, San Bernardino, and Riverside courts which service the inland Empire area.
How do you pay your bills while fighting your denied case?
If the workers’ compensation insurance company has denied your work injury and is claiming it owes you no temporary total disability (TTD), you may need to file for State Disability Insurance benefits with the EDD office near Fontana. While you try to overturn denial you can apply for this benefits through the California Employment Development Department (EDD) if you worked long enough in the past 12 months to have balance in your account assuming you have money in your disability account, these benefits will be paid up to one year. Also you should look into other potential wage replacement benefits as your employer may offer short-term disability or long-term disability as part of your employee benefits package. These additional benefits vary from employer to employer and or union agreements. Unfortunately, if you have a denied work injury or personal medical condition, you may need to use your personal time under the Family Medical Leave Act also known as FMLA.
Do I need legal help for my denied Worker’s Compensation claim?
If your case is denied, you are likely going to need legal advice and come up with a plan on how to deal with this. Your choices are to fight it or drop it. Contact the Fontana work injury lawyers at Cleveland & Metz for a free consultation and advice in Rancho Cucamonga, minutes from Fontana on Baseline Avenue. We will help you form a plan and give you an honest opinion of whether you need a lawyer or not. Check your rights, consultations are free as is our advice. You can handle this yourself, but some mistakes cannot be undone. Contact us for additional information.