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What happens if your workers' compensation claim is denied?

California provides robust labor protections. However, they are still subject to the biases of people. The first step in getting your claim approved is submitting it to the claims administrator. If the claims administrator denies your claim, then you have a few options.

First of all, if your claim is denied, you can seek assistance from the California government. There is a specialized department that assists workers with their appeals.

Your claim can be denied for a variety of reasons, including treatment, diagnosis, an injury that was not related to work and many other reasons. If the administrator denies your claim because he or she does not believe it is related to work or even an injury, then you can file a petition with an appropriate division office. You must file at an office in your home county or the county in which you were injured. Each of these offices has administrative courtrooms that will hear your petition.

In order to get a hearing, you are required to file what is called an Application for Adjudication of Claim. The application must also be submitted to other involved parties. If your application is accepted, you can then request a hearing date by filing a Declaration of Readiness to Proceed.

At the hearing, you will appear before the judge. The judge will discuss the case with you and the other parties, to try and negotiate a settlement. If you are unable to resolve the differences, then a date for the mandatory settlement conference will be set.

If you go to the mandatory conference, you will need to prepare documentation that outlines your claim and the reasons you believe it was unfairly denied. At this stage, it would be very helpful to have an attorney prepare and review your paperwork.

If you were injured on the job and your claim  was denied, then you may want to speak to an attorney. Your claim could have had an error on it or perhaps your employer was mistaken. Regardless, an attorney can help you sort through the mess to get your benefits approved.

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