A Guide to Reasons for Worker’s Compensation Claim Denial

Worker’s compensation refers to a system that protects the workers who sustain an illness or injury related to the job. It pays for the medical treatment of the injured employee. The worker’s compensation insurance company of the employer makes the preliminary determination on whether the work-related injury would be approved or denied. It is worth noting that insurance companies could save a good amount of money by denying the claims.

And, when the companies deny claims, they hope the injured worker would take their word that denial is valid and move on. And, numerous frustrated workers do so. According to the workers’ comp attorney, it is crucial to know the reason for the denial before you move on based on the insurance company’s word. There are numerous reasons for the denial of workers comp claims such as

·       Injury Not Happened at Work

For receiving the workers’ compensation, the illness or injury need to be the result from duties worker perform during employment. Therefore, one of the key reasons for denial is injury did not occur at the work. However, there could be numerous gray areas with such kinds of issues.

For instance, you are heading out for lunch and the boss gives you cash and asks you to pick up food for you and other workers. On the way to the food shop, you were injured in an accident. In such a case, the insurer might deny benefits as you were ‘off the clock’ during injury. However, even if you were out, you were still doing the work-related duty as the boss instructed you to make the trip.

Injury Not Reported Timely

For every state, there is a certain deadline to report work-related injuries. The top workers’ comp lawyers in Oakland CA suggest reporting the injury as soon as possible. However, with several other issues related to worker’s comp, things are not simple. For instance, certain injuries occur after an extended period like occupational illness, repetitive stress injuries, etc.

It might take time for you to notice such injuries as well as take the appropriate actions. However, again the insurance companies would take benefit of it and deny the claim in case they could find a reason for saying that you did not report injury timely.

Failure to Seek Immediately Medical Treatment

This is linked to the previous point, you might feel pain in the lower back as you picked a 100-pound box. However, you tried to tough that out, thinking the pain would go away eventually. After few days, you realized something was wrong and you required medical help. In such a situation, the insurance company might say you are faking an injury or it was not serious because you did not get treated for the injury immediately. 

The insurance company might even claim you did not do much to mitigate the injury’s extent. In case you, your friend, or colleague has been denied, do not give up as several denials are not legitimate. You might appeal your claim successfully and for that, you require legal counsel. In case you are looking for a reputed California worker’s comp attorney, the Law Offices of James E. Latimer is the best search result. They don’t even charge any fee until they earn the client the benefits. 

How can a Lawyer Help in Work Injury? Should you consider?

Protect Your Rights and Increase Your Workers’ Compensation Payout

Injury is unexpected and inevitable when you are working in the field. But again, you can always take the measures to ensure that things don’t get worst. An injury can turn out to be a disastrous turn in the life of an individual.

You know injuries can be really extreme too. What if a person gets handicap or get bedridden for months because of an injury during the office time in the office campus? It would be really risky and scary right? Without his or her fault; they might have to deal with the trauma that accompanies an injury. In such instances lawyers like work injury lawyer Oakland can help you. They would fight for you so that you get the compensation that you deserve.

Worker Compensation

Workers’ compensation is a type of insurance that is bought by your employer. You are not really expected or needed to contribute toward this cost. It caters for the cost of medical care and even that of lost wages should you turn out to be injured or ailed as a direct outcome of your job.

Why is it significant to hire the right attorney for worker compensating?

You know every workers compensation claim that gets paid out means simply a loss for the insurance firm. Hence, it is in their finest interest to make the payment received as low as possible. Without legal guidance, a person might not be fully aware of their rights in Oakland or of how much he can sensibly expect to be compensated for a wound or illness. This is main stands crucial and true because of the complication of workers’ compensation law and the distinctness of every case in Oakland. Taking bad advice in such a matter could simply mean that a person loses thousands of pennies in the wages and advantages he deserves to receive.

Are you reluctant?

Folks are often reluctant to take help of a lawyer because they fear that it is going to be too expensive. In reality, the maximum a person will be charged is going to be twenty percent of the settlement and at times less. You just pay only if you win and contribute nothing right away. You don’t even give money for letters or phone calls. Since lawyers do get compensated on the basis of a percentage of the settlement, they are amazingly motivated to help you receive the maximum amount.

Reasons to take help

There are various good reasons why it makes total sense to depend on the expertise of a great workers’ compensation attorney:

• A lawyer will ensure that you receive the benefits you deserve. He would keep into consideration that your average weekly wage sum is accurately documented and assist you to get the modifications, job training or other types of special additional benefits your wound may need.
• In case any type of issues emerges with your benefits, you are already going to have an attorney who is used to and friendly with the details of your situation. He can act swiftly on your behalf to reach out to a resolution.
• A seasoned attorney is familiar with the judicial system and also the complexities of workers’ compensation law. Nobody, not even supervisors or that of your family and friends who have experienced advantages in the past, are going to be as qualified to make recommendations to you related to settling your case. Certainly a work injury lawyer in Oakland has the expertise, experience and idea about everything and that can move mountains for your case.

Conclusion

Thus, don’t become a victim of your lack of knowledge and talk to lawyers today for work related injuries.

Also, Find the eligibility of Workers Compensation Claim.

Here's How You Should Prepare For a Meeting With an Oakland Workers Compensation Lawyer

You might be a little nervous before your first meeting with the workers compensation lawyer. This isn’t surprising given the kind of pain, suffering and trauma you may have gone through since your injury. Take a deep breath and get over all the fear and apprehensions you have in your mind. A workers’ compensation attorney is your friend and guide in this fight and shall offer suggestions and legal advice to ensure your rights and financial stability is protected. Here’s how you can prepare for the meeting.

# 1 Take Someone Along
Narrating a traumatic experience weeks or months after the incident is never easy. If you have been cold shouldered by your employer and have had to knock several doors for treatment and rehabilitation it becomes even tougher. You may have emotional breakdowns while talking to your attorney. Taking your partner, friend of colleague is always advisable as this adds to your mental strength. Make sure you take someone who is aware of all the events that have taken place so far and can answer questions that your lawyer might have and also correct you when you are missing out on important details.

#2 Prepare Chronology of the Events
As we have stated above, given the mental state you are in, it is quite possible that you’d forget mentioning details of how you have dealt with your injury and its aftermath. This is where it is advisable that you write down the chronology of the events in a piece of paper starting from how you got injured to how you were taken to a medical care provider. There are several things that your Oakland workers’ compensation lawyer would like to know from you such as - When did you inform about the injury to your employer? When did your employer provide you with the DWC-1 form? Did they ask you to resume work in a different role? While you don’t need to handover this paper to the lawyer it ensures that all the relevant details relating to your claim are made known to them.

#3 Get Your Documentation In Order
Any piece of document that you have relating to your injury, the treatment that you have undergone and all the correspondence you have had with your employer or the insurer should be presented during the consultation. A lawyer would need to review the documentary evidence before they are willing to take up your case. They should be convinced that the case is worth fighting and all that you state during the conversation is real and you have documentary evidence to prove that. Here are some of the documents that you should present to your lawyer -

• All relevant medical records and reports you have
• List of all the medical care providers you have referred to
• Copies of all the correspondence you have had with your employer and insurance company
• DWC-1 (First Report of Injury) Form if you have filled one

#4 Questions You Have For the Lawyer
You shouldn’t be overwhelmed meeting your attorney irrespective of their status and reputation. As a client you do have the right to know how the attorney would approach the case and what kind of outcome should you expect at the end. This calls for asking the right questions to your attorney. Here are some of the things that you need to ask your Oakland workers compensation lawyer before entrusting them with fighting for your claim –

• What kind of benefits should I expect from the case?
• What would be the timeframe for the claims to be settled?
• How much would you charge me?
• Do I have to pay you upfront?

To sum up, fighting a workers’ compensation claim is always a hard battle and it is important you hire the best attorney to fight your case. The above mentioned approach would ensure you are able to choose the right Oakland workers compensation lawyer and get started with your fight in the right manner.

Summary – In this write-up we take a look at some of the things you need to prepare when you are meeting your Oakland workers compensation lawyer for the first time.