Denied Claims

Santa Clarita Workers' Compensation Lawyers for Claim Denials

Denied workers' compensation claims can significantly stress injured employees and their families, touching every aspect of their lives. When you sustain a work-related injury or illness, you rely on workers' compensation benefits to manage medical expenses and cover lost wages during your recovery period. A claim denial can lead to financial hardship and uncertainty and even prevent access to adequate medical care, prolonging recovery and exacerbating stress. 

For employers, you may need legal help when claim denials lead to employee disputes or lawsuits. These disputes can involve the Division of Workers’ Compensation, a California Department of Industrial Relations branch that monitors such issues, or the Workers’ Compensation Appeals Board (WCAB). 

The Bridgeford Law Office, APC. advises, guides, and represents both employees and employers in all aspects of California workers’ compensation matters, including those involving claim denials. 

Contact a Santa Clarita Attorney for Your Workers' Compensation Claim Today online or at (661) 387-3712. 

Top Reasons for Workers' Compensation Claim Denials in California

Claims for workers’ compensation can be denied for several reasons, including: 

  • Disputed circumstances: The employer might contest the claim by asserting that the injury did not occur in the workplace or during work hours.
  • Delayed filing: Failing to report the injury or file the claim in time according to state laws can lead to a denial.
  • Incomplete documentation: Insufficient medical records or paperwork can undermine a claim.
  • Employer retaliation: Some employers may unlawfully retaliate against employees for filing a claim; this can result in wrongful dismissal.
  • Questions regarding the injury’s severity: Insurers may dispute the severity of the injury or its impact on the employee's ability to work. 

Steps Employees Can Take After a Claim Denial

If you have received a workers’ comp claim denial, you should carefully review the reason given in your case. If you believe your claim has been wrongfully denied, you can file an appeal within the timeframe state law allows. You must gather additional evidence, including medical records and witness statements, to support your case.

We recommend seeking legal counsel from a qualified California workers’ compensation attorney. Our firm’s team includes Workers’ Compensation Specialists certified by the California Bar’s Board of Legal Specialization, an achievement that only a small percentage of attorneys in the state earn and which categorizes them as legal experts in their field. 

How to Contest a Denial: Essential Steps to Follow

When your California workers’ compensation claim is denied, you can pursue a legal process to contest it.

The steps involved generally include: 

  • File an Application for Adjudication of Claim: The first formal step in disputing a denial is to file an Application for Adjudication of Claim with the Workers' Compensation Appeals Board (WCAB). This establishes a case with the WCAB.
  • Submit a Declaration of Readiness to Proceed: To request a hearing (known as a "mandatory settlement conference") before a workers' compensation judge, the employee must file a Declaration of Readiness to Proceed (DOR).
  • Mandatory Settlement Conference (MSC): At the MSC, both sides attempt to settle. The case will go to trial if a settlement cannot be reached.
  • Trial: At trial, both parties present evidence and arguments. After the trial, the judge will issue a decision.
  • Petition for Reconsideration: If you disagree with the judge's decision, you can file a Petition for Reconsideration with the WCAB within 20 days of the decision.

If the claim is still denied after a mandatory settlement conference and trial before a workers' compensation judge, the following steps are part of the appeals process:

  • Workers' Compensation Appeals Board review: The WCAB reviews the decision made by the workers' compensation judge if a Petition for Reconsideration is filed. The WCAB can uphold, adjust, or overturn the judge's ruling.
  • Filing a Writ of Review: If the WCAB denies the petition, you can file a Writ of Review with the California Court of Appeal.
  • California Court of Appeal: The Court of Appeal will examine the case to determine if legal errors were made in applying the law. They have the authority to uphold, modify, or reverse the WCAB's decision.
  • California Supreme Court: As a last resort, you can petition the California Supreme Court to review the case if the Court of Appeal's decision remains unfavorable. This court has discretion over whether to accept the case.

Timelines and specifics may vary, and navigating this process can be complex. Therefore, employees should seek advice or representation from an attorney specializing in workers' compensation law to optimize the chances of a successful outcome.

As a law firm that also represents employers, our capable legal team can advise and represent California businesses in our area in all of the above legal processes. 

Assisting Employers & Employees in Workers’ Compensation Claims Disputes 

The Bridgeford Law Office offers skilled and experienced legal services to both employees and employers embroiled in workers' compensation disputes. We advise injured workers on their rights and potential courses of action for appealing denied claims and help build strong appeal cases by gathering critical evidence and expert testimonies. 

We also assist employers in understanding the nuances of California workers’ compensation laws to avoid costly legal mistakes and represent them in court, if necessary, to reach fair and just resolutions.

By providing comprehensive legal support and representation to disputing parties, The Bridgeford Law Office can help to ensure that employees and employers in Santa Clarita and the surrounding areas navigate the workers' compensation system effectively and equitably. 

Whether through mitigating the burdens of a denied claim or helping employers manage their legal obligations, our firm fosters a climate of justice and compliance with workers' compensation laws.

Consult with a Santa Clarita workers’ compensation claims denial attorney via our online contact form or by calling (661) 387-3712. 

Representing Clients in the Santa Clarita Valley Since 1999

Don't face legal challenges alone. With decades of experience, practical wisdom, and advice, we're here to assist you every step of the way. Contact us at (661) 387-3712 to discuss your case with our team

Contact

Testimonials From Former Clients

    "Zach was my attorney and he was fantastic through the whole experience."

    I found Bridgeford Law and instantly felt like I made the right decision. Zach was my attorney and he was fantastic through the whole experience. Even the front office staff were great through my many times talking with them.

    The workers comp process in California is convoluted and the insurance companies do everything they can to stall and try to wear you down. The whole process Zach did great at keeping an open line of communication with me. He helped reassure me and I will forever appreciate that. I reached a favorable settlement and I was not disappointed with the results that Bridgeford law got me. I can honestly say I will always recommend them to my friends and family.

    - Nathan W.
    "I am eternally in your debt. Again, thank you."
    You have lightened my stress level considerably due to your diligence as well as your legal expertise; and the fact that you genuinely care about me as a person, not just a client. I am quite certain that ALL of your clients receive the same level of quality... and for that, I am eternally in your debt. So glad everything seems to be fast tracked and as bad as things are, there is finally light at the end of the tunnel, which for the 1st time, looks like it ISN'T the headlights of an oncoming train. At least this holiday season is far better than last year at this time, and that's directly due to you and your staff's hard work on my behalf. Again, thank you.
    - Former Client
    "He fought for me and we were awarded a more than fair settlement."
    I was referred to Mark by a friend and after our consultation, I knew he had my best interest in mind. He fought for me and we were awarded a more than fair settlement. I would recommend Mark and his staff to anyone in need. A very good group of people.
    - Mason U.
    "The Bridgeford Law Office has gone above and beyond!"
    The Bridgeford Law Office has gone above and beyond! Mark and his team has worked hard on getting treatment for my injury. If a procedure was denied by the insurance company, Mark and Emily are ready to work on getting medical care approved. I highly recommend this office for anyone who has a work related injury. Thank you Bridgeford Law Office for taking care of my claim.
    - Jose V.
    "Thanks to your efforts."
    At least this new year will be starting on a far better note than last year at this time. Thanks to your efforts this year at least my bills are paid, my medications are here, I'm not facing eviction and there's even plenty of food in case I get an appetite despite the pain. Thanks and have a great holiday!
    - Former Client
    "I will be eternally grateful to Mark and the entire staff of Bridgeford Law."
    I had the good fortune to choose Mr. Bridgeford to handle my work comp case...Not only is he an EXTREMELY skilled lawyer who prevented the insurance company from doing various nasty things to me, but his caring, legal expertise & wonderful staff prevented all of it from happening and the outcome of the case was better than I ever could have hoped for...He is without a doubt the finest work comp attorney in So. CA and if you need a great one, then he's DEFINITELY the right man with the right staff for the job...Despite this being a very complex case with 4.5 years of litigation, they were always very attentive to my needs and most definitely saw that justice was done...I have heard many stories of work comp clients getting screwed over and Mark made sure that that did not happen in my case...You will not regret choosing him...I will be eternally grateful to Mark and the entire staff of Bridgeford Law.
    - David F.
    "I would recommend them to anyone."
    I had a great experience with everyone at Bridgeford Law. So professional and extremely helpful! I would recommend them to anyone.
    - Samantha H.
    "Would highly recommend."
    Very pleased with this Law Office for Workmans Comp representation. Work hard and not a dime out of pocket. Would highly recommend.
    - Joel C.