Oakland Denied Workers Compensation Claim Lawyers
Was Your Workers' Comp Claim Denied? We Can Help!
If you were recently injured on the job, you may have filed a workers’ compensation claim and expected a favorable outcome. Unfortunately, just because you filed a claim does not necessarily mean it will be accepted. The Division of Workers’ Compensation (DWC) in California can deny your claim for a variety of reasons. The good news? You have the right to appeal their decision.
Before you make an appeal, however, it is helpful to know why your claim was denied. At Pacific Workers', The Lawyers for Injured Workers, we carefully assess each case and create an informed strategy based on our findings. Rather than blindly moving forward, our clients can count on calculated efforts every step of the way.
Fill out a free case evaluation form to tell our Oakland workers’ compensation attorneys more about your case!
Common Reasons for Claim Denials
A claim denial indicates that the claims administrator did not believe your work injury should be covered by workers’ compensation. You will be alerted of the denial by letter, at which point you have the opportunity to challenge the decision.
A claim can be denied for any number of reasons, including:
- Failure to report or file the claim on time
- The employer disputes the claim
- Injuries are not severe enough to warrant a claim
- Injuries were caused by stress, not work-related conditions
If you want to object to the denial of your claim, you must file both an Application for Adjudication of Claim and a Declaration of Readiness to Proceed. These documents indicate that you want your case heard by a judge. After a hearing and a trial, a decision is made about your case.
CAN YOU GET WORKERS' COMP IF YOU ARE AN INDEPENDENT CONTACTOR?
According to California labor laws, independent contractors are not eligible for Workers' Compensation through their employer, and are, in fact, responsible for their own Workers' Compensation insurance. However, that doesn't mean that you can't receive Workers' Compensation if you are an independent contractor. While that might seem like a contradiction, there's actually a very simple explanation: many people who are classified as independent contractors are really employees.
Misclassification is a common problem, rampant in industries like trucking. Countless businesses in the state and around the country misclassify part-time, or even full-time, employees as contractors in order to save money on benefits, social security, Workers' Compensation insurance, and payroll taxes. This is illegal, and there are penalties from the labor board and from civil court. Employees who have been misclassified as independent contractors are eligible for Workers' Compensation benefits, and are entitled to treatment when they get hurt.
Workers' Compensation cases involving misclassification are more complicated than average. There must be a trial at the Workers' Compensation Board to prove that the injured worker is really an employee.
There are many factors that go into proving employment status, the most crucial of which are:
- Does the employer provide the equipment necessary to do the job?
- Does the employer set the workers' schedule and tell them when & where to work?
If the answer to both of those questions is, "yes," you're most likely an employee, regardless of what kind of tax form you filled out, and an experienced Workers' Compensation attorney can easily prove the truth and get you the benefits that you deserve. However, there are some sectors in which labor law is still catching up with technology. For an example, the classification of Uber drivers is currently a gray area being worked out in the courts. But in most cases, the law is clear: injured workers who have been misclassified as independent contractors can receive Workers' Compensation.
What Happens If My Case is Denied?
It can be the worst feeling in the world: You got hurt at work, made sure to dot the I’s and cross the t’s when you filed your DWC-1 form, then took some much needed time to recover, only to be turned down by the insurance company. Receiving notice that your claim was denied — when your injury happened at work and you know the pain is real — can be frustrating, disheartening, or downright terrifying. Thankfully this denial letter isn’t the end of the road.
- Keep Treating Your Injuries: Medical bills can be difficult to keep up with without the aid of workers’ compensation, but it’s important that you do everything you can to address your injuries. This means sticking to prescribed medication regimens and going to follow up visits with doctors and therapists. Failing to do so can hurt you in two ways: Your injury may get worse, and you are giving the insurance agency more ammunition to poke holes in your claim.
- Who Can You Call? Don’t let a denied claim cast doubt on your injuries. Insurance companies deny valid claims all the time, knowing that most workers won’t fight back. But an experienced California workers’ compensation attorney can guide you through the complex legal process to force the insurers to accept your right to compensation.
- Workers’ Compensation Appeals Board (WCAB), Qualified Medical Examiner and Agreed Medical Examiner: The next steps illustrate the need for an experienced lawyer. Depending on the reasons your claim was denied, different legal approaches will be required. If the insurance company disputed some crucial fact to your case, such as whether you’re an employee, you’ll need to have a hearing before the Workers’ Compensation Appeals Board (WCAB). If the cause of your injury is what’s in question, you will need to see a qualified medical evaluator (QME) or an agreed medical examiner (AME) evaluate your claim.
Retain an Oakland Workers’ Compensation Lawyer
Before the appeals process, you have the right to obtain legal representation. We cannot emphasize enough how important this is – the attorney you choose can have an immense impact on the outcome of your case. Our firm is here to give you the best possible chance at a favorable decision and with 130+ years of experience, you can feel confident when we’re on your side.
Don’t wait! Your claim is bound by time constraints and should be handled proactively. Get in touch with Pacific Workers', The Lawyers for Injured Workers today. Offices in Oakland and Concord!
We have Helped OVER 8,000 CLIENTS aND WE CAN HELP YOU TOO!
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They didn't give up on me.
“Pacific Workers went to bat for me. Was I an easy person to get along with, no but they didn’t give up on me.”
David W.
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Thank you for being so kind!
“I started my fight against my company's workers comp and after talking to Almarie for the first time I already felt a lot of weight off my shoulders.”
Jazzie D. Daly City, CA
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I'm forever grateful & thankful to all!
“I especially want to thank Mr. Jason Insdorf, who worked in attaining a settlement I never expected.”
L.S. Union City, CA
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They took care of me!
“Bilal worked on my case and he was very professional, friendly, and kind to me. I was so nervous about my deposition and he made me feel very comfortable and less stressed about the whole situation.”
Gabi O. Sacramento, CA
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The most down to earth team I have ever met!
“They have strong communication and I was respected throughout the whole process. They had never given up on me!”
Nekealla C. Tracy, CA
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I got a compensation package that I was very happy with!
“My attorney provided me with a very smooth experience, patiently answered all my questions, and worked hard to represent my best interests.”
Dro L. Redwood City, CA
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I would highly recommend PWC!
“PWC's staff is knowledgeable and informative when it comes to answering your questions and ensuring you're well informed during the process.”
Patrick P.
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Your team was great to work with!
“You took nothing and made it out of something. I felt like I mattered! Everyone was very professional and caring.”
Heather Flores Bakersfield, CA -
“¡Farber hizo que fuera muy fácil y sin estrés para mí! Ellos hicieron todo el trabajo duro y me hicieron sentir tranquila en la situación que estaba atravesando. Nunca habría esperado que el resultado fuera tan bueno. Me mantuvieron al día de todo lo que pasaba en mi caso. Todos los abogados con los que traté eran tranquilizadores y positivos. Recomendaría a Farber a cualquier empleado que necesite ayuda con su compensación de trabajadores.”
Janette D. -
Pacific Workers' Comp is one of the best places to get help from when you need help with an injury from work!
“Iana and Sergio are very helpful, and Pacific Workers' Comp is one of the best places to get help from when you need help with an injury from work they have been helping me out through my trying time and doing a damn good job with dealing with stuff that I can't handle and I really appreciate all their help if you ever need help with an injury at work this is the place to go.”
Lamar B. Santa Clara, CA -
Bilal is very professional, caring and committed to his clients!
“My lawyer Bilal took the time out on a late Friday afternoon to meet with me and answer some questions that I had. Who stays late and meets with you on a Friday afternoon? Very few do, Bilal does. It speaks to his professionalism, caring, and commitment to his clients. Which creates a culture value at PWC. This is only one example of my experience with them, there are many more just like this.”
Guy H. Novato, CA -
PWC has provided me with exceptional care!
“My experience with them has been exceptional. They are caring, devoted and professional. They had turned a stressful situation into one that does not cause anxiety.”
Jaaziel B. -
The attorneys and employees at PWC are angels!
“Thank goodness for my team of lawyers and assistants that always take the time to listen to my concerns, answer my questions, and act on my behalf when my company does nothing!! Someone else said it, and I second that the people at PWC are angels!! At least I feel that someone is on MY side now!”
Heikelyn J. -
I was lucky enough to obtain the services of Pacific Workers' Compensation Law Center!
“I was lucky enough to obtain the services of Pacific Workers' Compensation Law Center. They worked tirelessly to receive the best care, and finally a C&R settlement from SCIF for me. Without them, I would have been just another injured worker without medical treatment.”
Martha M. -
For anyone out there looking for a 'Worker's Comp attorney,' look no further!
“For anyone out there looking for a 'Worker's Comp attorney,' look no further. Robert Davis is the man you want on the case. Robert truly cares for his clients; he will help you through the tough times, with a no-nonsense approach to your situation. Robert is a good man that never leaves any doubt in your mind and always makes you feel like he is the best man for the job.”
Francisco P. Hayward, CA -
Exceptional Customer Service
“I would recommend Pacific Workers' Compensation Law Center to my family and friends. I was so blessed to talk with AlMarie in March 2018 after receiving horrible service from another attorney's office. AlMarie took the time to talk to me and give me the information that I needed. Lauren and Alex are super great, and I feel I made a good decision for the law center to represent me. I received my packet with great information, resources, and how to communicate and contact the team who will be assisting me and working on my case.”
T. Davis Addison San Leandro, CA -
Jason exuded complete confidence in my case & really understood what I went through!
“My attorney Jason Insdorf exuded complete confidence in my case and made me feel like he really understood what I've been through (didn't hurt to read about his extensive credentials and expertise specific to my case). Karla Ortega made me feel at ease, listening intently when I explained details dating back 12+ years. Also, I was very impressed by the compassion, communication, and overall professionalism.”
Matthew U. Modesto, CA -
Pacific Workers' Compensation helped me get the justice I deserved!
“It was my first injury at a job and I did not know what to do. I did not know if my rights as an employee were being met. So, I was able to call to ask Pacific Workers' Compensation about my injury that occurred and what were my rights as an employee. They were able to help me get justice.”
Victoria M. Santa Cruz, CA -
After Pacific Worker's Compensation started handling my case, I started getting the respect of an injured worker and not just a number.
“My caseworker is amazing. She is quick to respond to my messages and concerns. Before contacting Pacific Worker's Compensation, I was getting the run around with my doctors and worker's compensation insurance for my employer. After Pacific Worker's Compensation started handling my case, I started getting the respect of an injured worker and not just a number.”
Brandy L. Fairfield, CA -
Bilal is always kind, professional, compassionate and explains everything thoroughly!
“Bilal Kassem is the nicest attorney a person dealing with a workers compensation mess can ask for. Always kind, professional, compassionate, and explains everything clearly.”
Emi B. Vallejo, CA -
They were a headache & stress rellief!
“Kiki was such a help. She works with Robert Davis. After dealing with the ins Co and there run around, blood pressure tossing, I turned my case one to PWC. No more headaches, no stressing, just relief. Thank you, Kiki and Robert & Pacific Workers Compensation.”
Debra McLaughlin Benicia, CA
Proudly Serving Northern California
Workers' Comp FAQ
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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.
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Do independent contractors get workers’ compensation in California?
No, most independent contractors are not covered by workers’ compensation insurance that is provided by their employer. The law does not require most employers to offer this sort of employment benefit to independent contractors. To get workers’ comp as an independent contractor, you will usually have to purchase a policy on your own.
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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.
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What If My Employer Denies My Workers’ Compensation Claim Because I’m a Seasonal Worker?
Employers in California are legally required to provide workers' compensation coverage to all employees, including seasonal workers. If your claim is denied, it's advisable to consult with a workers' compensation attorney to understand your rights and explore options for appealing the decision.
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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.
