Can My Employer Deny My Claim?
It is unlawful for your employer to deny a covered claim if you are injured at work. Your employer is required by law to obtain workers’ compensation insurance — or qualify for self-insurance – and to pay for the cost of medically treating your injuries. Within one day of reporting your injury to your employer, your employer is required to provide you with a workers’ compensation claim form. Your employer is also required to authorize medical treatment immediately. If available, your employer is required to provide you with light duty work.
Some employers will deny an employee’s claim by misclassifying the employee as an independent contractor. While there is no one definition of an independent contractor, generally independent contractors are completely in control of the hours they work, how their work is completed, and the finished product. Other factors the Department of Labor and courts use to determine independent contractor status include:
- Who is supplying the tools of the trade being used
- Whether you are being paid an hourly wage or by the project
- Whether you are engaged in a distinct occupation or business
If you are injured at work and your employer denies your claim, seek the help of an experienced worker’s compensation attorney as soon as possible. I am attorney Douglas Webster and I help workers throughout San Diego County fight the denial of their workers’ compensation claims. Call me at 858-951-1022 to protect your right to collect workers’ compensation.
Can The Insurance Company Deny My Claim Or Treatment?
Even if you caused your injuries at work, you can file a workers’ compensation claim for benefits. If your claim has been denied, you can challenge the denial but you must do so quickly.
Insurance company representatives deny claims for various reasons. Some claims are denied because a claims administrator believes the injury is not a qualifying injury. Sometimes, medical treatment is denied after a utilization review because the reviewer deems the treatment your doctor has ordered to be medically unnecessary. When this happens, you have options. However, determining your best option can be complex and so can developing your case to present to the Workers’ Compensation Appeals Board (WCAB). It is also important to keep in mind that you have a limited amount of time to take action after a denial, including requesting that your case be adjudicated or seeking a Qualified Medical Evaluator (QME) for a medical evaluation.
We Provide The Help You Need When Your Workers’ Compensation Claim Has Been Denied
My primary focus is helping injured workers get the compensation they need to help them recover from their injuries. If your workers’ compensation claim has been denied, time is of the essence. Email me or call me today at 858-951-1022.