What to Do If Your Claim Is Denied

Posted By Law Offices of Wax & Wax || 21-Dec-2016

Has your workers’ compensation claim been fully or partially denied? Are you concerned you won’t get the treatment or compensation you need to recover? The Law Offices of Wax & Wax want you to know that you still have a chance. If you’ve been denied, contact our Glendale workers’ compensation attorneys today, and we will help you take the following action:

Contact Your Insurer to Find Out Why Your Claim Was Denied

In order to challenge the denial of your claim effectively, you will need to know the insurance company’s reasons. Claims can be denied for various reasons, but some of the most common explanations the insurance companies provide include:

  • You were not injured on the job
  • There is no medical evidence to support your injury
  • The injury was the result of a preexisting condition
  • They do not agree with the treatment plan
  • You failed to provide required documents or incorrectly filled them out

Once you are aware of why your claim has been denied, you can make an informed choice about whether it will be worthwhile to challenge the decision.

File an Application for Adjudication of Claim

If your claim has been denied, you can file an Application for Adjudication of Claim. This document will require you to provide all of the relevant information regarding your injury and your workers’ compensation claim. While you can make the case on your own, it will be to your benefit to employ the experience of a Glendale workers’ compensation lawyer.

Be Evaluated by an Approved Medical Examiner

You must have a medical examination performed by a Qualified Medical Examiner (QME) or Agreed Medical Evaluator (AME). This examination will be used as evidence when it comes to determining the validity of your petition.

Present Your Case Before a Judge or Board

Finally, your case will be considered before a judge or review board at a hearing. Once you and the insurance company have presented your arguments to the judge, a decision will be made.

Don’t Petition Alone – Get 100+ Years of Combined Experience on Your Side

Contesting a denied workers’ compensation claim is a difficult and tedious process. To ensure that your compensation is taken seriously and that your claim is approved, you will need the help of an experienced Glendale workers’ compensation attorney. The team at the Law Offices of Wax & Wax knows what it takes to petition a denied claim successfully. Call 818-946-0608 for a free case review!

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