Denied Workers’ Compensation Claims

Experienced Modesto Workers’ Compensation Attorneys

If you are injured at work or while performing any act that benefits your employer in the state of California, you are entitled to workers’ compensation. There are very few exceptions to this; in most cases, employers must provide workers’ compensation regardless of how many employees they have, whether the employee works part-time or full-time, and without regard to the employee’s immigration status. However, actually obtaining your rightful benefits is not always easy.

Workers’ compensation claims are denied for numerous reasons. Your employer may not have the required workers’ compensation insurance, despite the law. When this is the case, injured workers may sue their uninsured employers and seek compensation through the Uninsured Employers Benefit Trust Fund (UEBTF). A claim may also be denied if your employer’s insurance provider argues that your injury is not covered by workers’ compensation.

Rancaño & Rancaño, APLC can help you if your workers’ compensation claim has been denied. Our Modesto workers’ compensation lawyers serve injured workers and their families throughout the Central Valley.

Call us today at (916) 884-6554 or contact us online for a free consultation. Se habla español.

Appealing a Denied Workers’ Compensation Claim

If your workers’ compensation claim was denied because your employer or your employer’s insurance company is arguing that your injury is not covered, you may appeal the decision. To do so, you will need to request a hearing before the Workers’ Compensation Appeals Board. At this hearing, a judge will hear your side of the case, as well as your employer’s side. The judge will then decide whether to reverse the claim denial or uphold it.

If the judge sides with your employer’s insurance provider and upholds the claim denial, you may also appeal this decision. You will need to file a Petition for Reconsideration within 20 days of the judge’s decision (or 25 days if the decision was sent to you via the mail). Once you have filed your Petition for Reconsideration, you will receive a decision within 60 days. The board will either accept, reject, or modify the original workers’ compensation decision or benefits.

There are additional steps to appealing a decision if you are unhappy with the outcome of your Petition for Reconsideration. We strongly recommend that you work with an experienced workers’ compensation attorney if you wish to appeal a denied claim.

How to Request Benefits from the Uninsured Employers Benefit Trust Fund (UEBTF)

If your employer does not have the ability to pay your claim, you can request funds from the UEBTF, which is a state agency designed to compensate injured workers who are unable to obtain benefits through their employers. Requesting such benefits involves suing your employer for not having workers’ compensation insurance/failing to provide rightful benefits.

To request benefits from the UEBTF, you will need to do the following:

• Notify your employer by providing a Special Notice of Lawsuit
• Send relevant medical reports and bills to the UEBTF for consideration
• Send the UEBTF proof of your employment (W-2, paystubs, etc.)
• File a Petition to Join Party Defendant UEBTF

In most cases, you must bring your civil action against your employer within three years of the date of the injury/date you knew or reasonably should have known you were injured. If you fail to adhere to this statute of limitations, your case will likely be thrown out.

Put a Proven Team on Your Side

Appealing a denied workers’ compensation claim in California is possible, but it can also be difficult. Our Modesto workers’ compensation attorneys understand the various processes involved and can help you take immediate action to fight for the fair benefits you are owed. We are here to answer your questions and provide you with the personalized legal guidance you need and deserve.

View our recent case results to learn more about how we’ve helped injured workers throughout California’s Central Valley over our 30+ years in practice! Our firm proudly serves clients in English, Spanish, and Portuguese.

Contact us online or call (916) 884-6554 to request your complimentary case evaluation.