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What can I do if my work injury claim is denied?

If you are a worker in California, you may have concerns about the proper reporting of workplace injuries. In some cases, your claim may be denied if a particular injury is not considered to be worthy of coverage. To this end, there are steps you can take to appeal your denial, which is imperative for getting the compensation necessary to make a recovery.

As stated by California’s Department of Industrial Relations, filing an Application for Adjudication of Claim is an integral component of appealing a denial of benefits. You will need to provide this document to the Division of Workers’ Compensation, as well as the claims administrator involved in your case. To file a claim you must locate your county’s office if you work in the same area where you live. If you work in a different county, you will file the document within that office.

Once this application has been received, you will be notified and must then request a hearing. The ultimate goal of the hearing is to reach an appropriate settlement, which will be at the discretion of the judge presiding over your case. Failure to do so will result in a trial, wherein you must present evidence that your injuries are the result of workplace practices. A decision is usually issued from one to three months after a trial takes place.

During the process you may be asked to visit a medical professional for an evaluation. This occurs when your primary doctor makes a claim about your condition that is disputed by the claims administrator. In some cases, your legal team and the claims administrator will work in conjunction to find a suitable doctor to perform the evaluation. 

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