For those who are injured while on the job, workers’ compensation can provide essential benefits, ensuring that their medical care will be paid for and that they will be compensated for some of the income they have lost. However, there are some situations where workers’ comp claims may be denied. In these cases, injured workers will need to understand their options for filing an appeal, including when their case may be heard by the California Workers’ Compensation Appeals Board (WCAB).
Requests for Reconsideration Before the WCAB
While all work-related injuries should be covered by workers’ compensation, regardless of who was at fault, there are a variety of reasons why a person may be denied benefits. An employer or their insurance company may believe that a person’s injuries were not work-related, or they may claim that certain types of medical treatment are not necessary. Disputes may also arise regarding whether an injury has resulted in a disability, and a worker may be denied temporary or permanent benefits that should address the loss of income they have experienced.
If a workers’ compensation claim is denied, a person will need to go through a specific process as they respond to this denial and request a review of their case. In some cases, a person may be able to resolve disputes by working with their claims administrator, or they may be able to negotiate a settlement with their employer. If a case cannot be resolved through these methods, a trial may be held before a workers’ compensation judge, who will review evidence and testimony and make a decision about whether benefits should be granted.
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