Appealing a Denied Workers' Comp Claim

Suffering injuries on the job is an unfortunate risk that affects everyone. That’s why the workers’ compensation system was created: to protect business owners from costly lawsuits but also to ensure those who suffer an injury while working receive the care and treatment they need. Employers have the right to deny claims from their workers when they believe the injury was not acquired due to their working duties, but if this denial is wrongful, a worker also has the right to appeal.

Attorney Ana Gomez-Garcia discussed the start of the appeals process in a video posted to Reed & Garcia Law, P.C.’s YouTube channel, including a lot of information that you need to know as an injured worker who has had their claim denied. You can watch the short, two-minute video here:

Here are some of the main points that Attorney Gomez-Garcia touches on:

You Need Sufficient Evidence

Appealing a case denial isn’t going to do anything unless you have evidence to show why your employer was wrong in denying your claim. This means you’ll need evidence, including your statement and testimony, statements from family members, friends, or co-workers, and anyone else who can verify that you have reported sustained a work injury as well as receiving medical treatment for that injury.

You’ll also need medical reports to document the progression of your recovery, the treatment you have received (including the doctors who have provided it), and the severity of the injury at the outset.

Beginning the Appeals Process

You can file your appeal with the appeals board in either the city where you live or the city where your employer is located, if the two are different. There are offices all around Los Angeles, Orange, and Ventura Counties.

When you are ready to file your appeal, show up and ask to speak with an information and assistance officer, or I&A officer. The I&A officer’s job is to help you with any questions you may have regarding your work injury and your rights as an injured worker. These officers also help you file your appeal and request a hearing before a workers compensation appeals board judge. The judge is who ultimately makes the decision regarding whether to grant you your appeal or deny your claim.

It’s also strongly advised that you work with a skilled Culver City workers’ compensation attorney who can assist you in acquiring the evidence you need as well as represent you when you plead your case before your judge.

Reed & Garcia Law, P.C. understands the importance your case has in your life, and makes it their mission to help you get the results you’re looking for when your case has been unfairly denied by your employer.

Whether you’re just starting your workers’ compensation claim or you’re looking for assistance after your claim has been wrongfully denied, call Reed & Garcia Law, (310) 242-8933 to request a free initial consultation!