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Workers' Compensation Denied Claims

Bakersfield Workers' Comp Lawyer: (661) 460-5557

When a claim is denied, you will receive a denial letter stating the reasons for the denial from the claims administrator. A claim can be denied for a number of reasons, including technicalities and medically unjustified injuries. But a denied claim is not the end of the process - you have the right to challenge the decision by filing an appeal with your local workers' compensation office.

If your claim has been denied for whatever reason, talk to our Bakersfield workers' compensation attorney to learn more about what your options are and how to dispute the denial. Read about the appeals process here.

Start with a free consultation.

Common Reasons Why Claims Are Denied

Workers' compensation insurance is like any other insurance. They are a business looking to protect their bottom lines, not the workers who should benefit from them. Insurance companies often look for even the most minor reasons to deny a claim, so it is always important to have an attorney look over your denial letter.

Claims are commonly denied because:

  • Worker waited too long to file - your claim must be filed immediately.
  • Insufficient documentation - your application may not have included the necessary documents by a medical provider to show that it is work related.
  • Employer disagrees with claim - your employer may dispute that the accident happened at work or is work-related.
  • Not medically justified - the claims administrator may not view your condition as severe enough to justify benefits
  • Unapproved medical provider - the doctor who treated you may not have been within the network of providers approved by the workers' compensation insurer.

Objecting to a Denied Claim

If you want to dispute a claim that was denied, you have the option of pursuing an appeal. An attorney at our firm can help you file an appeal with the local workers’ compensation office and walk you through the entire process, including the paperwork, additional documentation, and any hearings that arise.

Give us a call at (661) 460-5557 to discuss your denial.