Workers' Compensation blog

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We think we know why your workers’ compensation claim was denied

On behalf of Mitchell Law Corporation
January 25, 2019

Is your workers’ compensation claim taking forever to gain an approval? Has it flat-out been denied?

We think we know why — and we may be able to help you overcome the problem.

There are some fairly common reasons that a workers’ comp claim can be denied. No matter how valid your injury, no matter how sincere you are about your inability to work, your case can fall apart because:

1. You had a pre-existing condition

Workers’ comp insurers love to argue about whether or not an injury is really work related. So what if you fell down a ladder at work? That minor bit of age-related arthritis you have in your lower back could be the real culprit behind your debilitating injuries, right? Wrong (but that won’t stop the insurance company from trying to argue about it).

2. You were injured off-site

Workers’ comp only covers injuries that are work-related. Sure, you were in a company car and were between meetings with the company’s clients when you were injured in a car accident, but how does the insurance company know you were really working at the time? (Again, an argument doesn’t have to make a lot of sense for an insurance company to try it.)

3. Your injury isn’t severe enough

California’s laws are rather specific about what constitutes a severe injury — severe enough, anyhow, to justify a workers’ comp payment. Insurance companies will sometimes comb through an injured worker’s medical records looking for some way to shade the diagnosis so that doesn’t seem to fit the requirements for benefits.

When any of these things happen, it’s important to have strong, experienced legal representation on your side. Our office will start a thorough review of all of the evidence in your workers’ comp case. We aim to put our clients on the best legal footing possible — using facts, not the insurance company’s version of reality — as we pursue what is rightfully due. For more information, please visit our main pages.

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