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What Happens When Benefits End or Are Denied

Orange County Law Firm Helps When Workers’ Compensation Benefits Are Denied

Providing more than a decade of experience to your case

Tous Law Group has assisted hundreds of workers in recovering fair compensation after a work-related accident. If your claim for benefits has been denied, it is time to seek help from top-quality lawyers. We understand the stress related to your injury has been compounded by your claim denial. Let us review the facts surrounding your case and provide you with the aggressive and competent legal representation you need to obtain a successful result. We are focused on recovering the benefits and monetary award you deserve for your damages suffered.

What happens when benefits are denied?

Workers’ comp benefits can be denied or delayed for a variety of reasons. Common reasons a claim may be denied are:

  • Claim was not timely reported or filed.
  • Employer disputes the injury occurred while at work.
  • Injuries are not severe enough to warrant workers’ compensation benefits.
  • A doctor concluded you were not disabled as a result of your work injury.
  • Your injury was caused by a preexisting injury or condition.

If your claim is denied, however, don’t give up hope. A workers’ comp attorney can review your claim and the denial and determine whether you should appeal the decision.

What kind of evidence supports a claim for benefits?

If your claim has been denied, it may be necessary to gather evidence supporting the validity of your claim. Evidence can come in numerous forms, such as:

  • Medical records
  • Witnesses to the job-related injury
  • Video of the injury occurring (surveillance video or cell phone video)
  • Audio evidencing the injury
  • Accident reports filed by another employee who incurred similar injuries while using the same equipment or device

Our legal team can help you gather the necessary evidence to support your claim. We may even investigate your employer’s record of handling workers’ compensation claims to determine if there is a history of denying valid claims.

What is the appeals process?

If a dispute arises concerning your claim, the first stage for resolving it is a hearing in front of a workers’ compensation judge. The next stage is an appeal of the judge’s decision for review by the Workers’ Compensation Appeals Board. The third stage is an appeal to a California appellate court, such as the California Court of Appeals or the California Supreme Court.

What happens when benefits are ending and I still can’t work?

Throughout your recuperation, your physician informs your employer or insurance carrier of your condition and when you are ready to return to work. If you return to work and your job is still too demanding, but your workers’ compensation benefits ended, you may need to ask your employer for a modified or less demanding job. You may also need to ask your doctor to take you off work eligibility until you have fully recovered from your injuries. If you cannot get the relief or help you need, contact Tous Law Group for help.

Seek assistance from skilled workers’ compensation attorneys in Orange County

If you suffered a workplace injury and your claim for benefits has been denied, contact Tous Law Group at 714-602-4473 or via our online contact page for a free consultation. We have offices in Costa Mesa, CA, Los Angeles, San Francisco and Corona. At our Orange County location, the parking is free and our office is easily accessible to public transportation. And remember, no recovery means no attorney’s fees!