Any kind of serious injury or illness can be a drain on the finances and a worry for the whole family if the main breadwinner is involved. When the injury or illness is workplace related, there is usually a good chance of reclaiming most, if not all of the medical expenses and a percentage of lost earnings by filing a workers’ compensation claim. These claims are possible when your employer has taken out insurance to cover their workers in the event that they are injured or become ill at work. The State Compensation Fund – Company Profile If you live and work in California, there is a good chance that your employer has workers’ compensation insurance with the State Compensation Fund. This is a business that is partially linked to the state government and is specifically designed to provide workers’ comp. insurance products. The State Compensation Insurance Fund was first established in 1914 by the state government of the time by popular mandate. Workers’ compensation was a controversial subject at the time amongst employers. Tips to Help You Decide on What to Do After a Workers’ Comp. Claim Has Been Denied There are several reasons why a workers’ comp. claim has been denied. The reason(s) will be outlined on the letter you get from the state workers’ comp. board that states that the claim was denied. There are often very simple, straightforward reasons why the claim was denied and you may be able to reverse the decision with the help of a qualified workers’ comp. attorney. Tip#1. Check the denial letter for the exact reason given for the decision. Is it something you can do something about? If you are unsure, talk to an attorney. Tip#2. The denial may be something to do with your employer or your employer’s insurer. A simple administrative mistake on the part of someone in an office may have resulted in incorrect information being supplied to either the insurer or the compensation board. If so, you may be able to reverse the denial decision quite quickly. Tip#3. If you did everything related to your claim on time (you needed to inform your employer as well as submit a claim within a specified time period) and there was no simple administrative error as far as you can make out, you should contact an attorney to get advice about an appeal. If an appeal is advised, this should be made within the specified time allowed after the decision about the original claim was issued. Tip#4. Your attorney may advise you to obtain better or more detailed documentation. This will depend on the reasons given for the denial. If your employer claims that an injury did not happen on the job, then you will have to find proof that it did. The injury should have been recorded by a supervisor after it happened. You may not have sufficient evidence of medical treatment and costs. This should be obtained from doctors, medical centers or hospitals before the next step in the appeal takes place. Tip#5. Take all the documentation you have, old and new, along to the administrative hearing which will be scheduled some time after your appeal is received. A judge will hear your grounds for a reversal of the denial decision and examine any new evidence you have brought with you. Use an Experienced WC Attorney if Contemplating Appealing a Denied Claim Even if you filed the original workers’ comp. claim without the help from an attorney, you should still use the advice and legal expertise of one if your claim is denied. The attorney will have handled cases like yours many times before and will be in a position to judge what sort of documentation or other evidence will help you when you appeal the decision. *The content of this article serves only to provide information and should not be construed as legal advice. If you file a claim against State Compensation Fund, or any other company, you may not be entitled to any compensation.
