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Workers’ Compensation Denials in San Jose

Call Our San Jose Law Firm If Your Claim was Denied

If you were hurt on the job, then you should be able to depend on workers’ compensation benefits to get you back on your feet. However, many workers’ compensation claims are denied when they are first filed. The denials can be issues for a variety of reasons, but you don’t need a variety of law firms to help with your case. Pacific Workers', The Lawyers for Injured Workers in San Jose can offer all the legal counsel and representation that you need to challenge a workers’ comp denial.

An appeal can be used to challenge the denial, and our attorneys are well-versed in all steps of a workers’ comp appeal. We are here to assess your case, uncover why it was designed, and strategize an appeal based on our findings.

Learn more today by calling us at (888) 740-6434 and asking for a free case evaluation.

Why Workers’ Comp Cases are Denied

It might be tempting to assume that your workers’ compensation claim was denied for incorrect reasons. Yet there are many legitimate reasons why a claim can be denied. One of the first steps when helping with your denial is to review the denial letter to find the reasoning behind it.

Workers’ compensation claims can be denied for these reasons and more:

  • Failure to file the claim on time.
  • Employer argues the accident or injury was not work-related.
  • Injuries are not severe enough to need medical attention or cause lost wages.
  • Accident was never reported to the employer.

Steps to Challenge a Denied Claim

If we determine that the reason for the denial was mistaken or unjustified, then we can file an Application for Adjudication of Claim and a Declaration of Readiness to Proceed. Using these documents, we can move your case to be heard by a judge during a hearing.

In some cases, the hearing will move to a trial, too. We can prepare your case for arguments in a hearing and challenges that come up during a trial. No matter what we will fight for the denial’s reversal.

Depending on the outcome of the trial or hearing:

  • Your workers’ compensation benefits could be instated and provided as they should have been from the beginning; or,
  • You could be given a settlement that pays for the benefits that you require as well as other losses caused by the accident and denial.

Denials for Independent Contractors

Are you employed as an independent contractor, got hurt at work, and were unable to get workers’ compensation? Please call (888) 740-6434 as soon as possible. With an investigation, our San Jose workers’ comp denial attorneys might be able to prove that you should have been classified as an employee, not an independent contractor, which would make you eligible for workers’ compensation insurance coverage paid for by your employer.

You might be a misclassified employee if your employer requires you to:

  • Work on a set schedule and chooses your workplace.
  • Wear a certain uniform and follow precise instructions.
  • Use tools or equipment provided by the company.

We have helped many local workers who filed their taxes as independent contractors because that’s what their employers called them, but who were actually employees under legal definitions. This could have happened to you, too, so let’s find out by discussing your options today.

Get Legal Help for Workers’ Comp Denials

Don’t accept a workers’ compensation claim denial at its surface value. We encourage you to always at least talk to our attorneys from Pacific Workers', The Lawyers for Injured Workers. During an initial consultation, we might be able to find a few solutions and ways to appeal the denial, so you can get the workers’ comp benefits that you need to recover from a workplace accident.

We look forward to hearing from you. Dial (888) 740-6434 at any time.

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Workers' Comp FAQ

  • Am I Eligible for Workers’ Compensation?

    In California, all employees are eligible for workers’ compensation with very few exceptions. If you are classified as an “employee” (rather than an “independent contractor”), you are eligible to receive benefits. This is true regardless of how many employees your employer has, how many hours you work, how much you make, whether you work part-time or full-time, or whether you are a seasonal worker. Additionally, undocumented workers are also eligible for workers’ compensation granted they meet all other eligibility requirements. In contrast, independent contractors and certain other workers, including some volunteers, household workers who are employed by a family member, and others, are not able to file for workers’ compensation benefits.

  • Can't I Just File for Workers' Compensation on My Own?

    Filing for workers' compensation on your own increases the chances that your claim will be denied. One small misstep can prevent you from obtaining the compensation you need for your injuries. In addition, the process is usually complex and tedious, especially for someone with no workers' compensation law experience. It is extremely advantageous that you seek reliable and experienced legal guidance for your claim.

  • What Can I Expect from the Workers' Compensation Process?

    As soon as you reach out to us for help, we will assign you a full-time case manager and attorney. An application will be filed with the Workers' Compensation Appeals Board (WCAB) on your behalf. We will get started on your case immediately to help you receive the medical care you need. If we are unable to receive a fair settlement from the insurance company, we are ready and willing to take your case to trial. After a few months, you will most likely give a deposition. One of our highly experienced attorneys will prepare you and stand at your side the entire time. You don't even have to attend court hearings! One of our trained hearing officers or attorneys can attend on your behalf.

  • Can My Employer Tell Me to Use Sick Time or Vacation/Personal Time off (PTO) If I’m Injured at Work?

    Following a work-related injury, you may not receive workers’ compensation benefits right away or your workers’ compensation claim may be denied. You may receive a note from your doctor that you may take time off work due to your injuries, but how will you be paid if you are not actively seeking workers’ compensation benefits? Your employer may tell you to use your state-mandated/employer-provided sick time in order to continue being paid while you are out of work. Once this sick time is exhausted, your employer may tell you that the only way you can continue to be paid is if you use your vacation or PTO time. In some cases, this may actually be the only way to continue receiving wages while you are out of work and not receiving workers’ compensation benefits. For more information, check out our video with Attorney Bilal Kassem on this topic by visiting our Facebook page!

  • Can I Get Workers’ Compensation If I Was Fired?

    If you were terminated while already receiving workers’ compensation benefits, this does not necessarily affect your right to receive benefits. However, if you were terminated “for cause” (for example, if you were fired because you were caught stealing from your employer), you will not be able to continue collecting benefits. If you were not fired for cause, but were laid off due to your position being terminated or various other reasons, you may still be able to continue collecting your workers’ compensation benefits. If you believe you were terminated because you filed for workers’ compensation or because you were hurt at work, you may have grounds for a retaliation claim. Learn more, including whether you can continue receiving workers’ compensation benefits if you were laid off due to the coronavirus pandemic, see our video with Attorney Bilal Kassem on our Facebook page.

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