California employers are required by law to carry workers’ compensation insurance for their employees so that if they are injured on the job, their medical bills, lost wages, and other expenses can be paid for. This is a major expenditure to employers, and those with more claims on their record will have to pay more to keep their policy and thus be able to stay in business.
Therefore, if you are injured on the job, do not be surprised if your employer seems as though they are fighting back against you to try to either have your claim denied or mitigated. This is called employer bias, and it unfortunately plays a big role in a number of workers’ compensation claims.
Common Reasons for Claim Denial
Employers will use a number of excuses to have your claim denied by their insurance company, thus saving the insurance company money, and in turn your employer money by keeping their premium costs for workers compensation’ insurance reduced. Likewise, this helps prevent them from paying out insurance costs for injuries that are either not serious, or non-existent and are merely claimed to receive financial gain.
Your claim may be rejected if your injury was not serious enough. If you get a minor paper cut at work, you most likely will not need to file a workers’ compensation claim, and if you do, it will most likely be denied since you can be treated with a small adhesive bandage. Your employer may also claim that your injury did not take place during work hours or within the scope of your job duties. If you were at work doing something that isn’t necessarily part of your job, your employer may deny your claim based on the fact that you created a risk for yourself, and not by the instruction of the company.
Your insurance company can also claim that you were not injured severely enough to require medical treatment or time off from work, thus requiring them to compensate you and a workers’ compensation claim. This is often a claim used for things such as carpal tunnel syndrome or other repetitive motion injuries where there may not be any obvious evidence of the condition. X-rays or other medical evidence may not be able to wholly verify the condition, which may also lead to a claim denial.
Make Sure You’re Protected
While employer bias is a very real thing, you can protect your interests by reporting your injuries in a timely manner, keeping detailed records of injury reports and doctor visits, and taking your situation seriously. It is important to be honest about the extent of your injuries, as inconsistencies in your story can come back to hurt your case.
If your workers’ compensation injury claim has been denied by your employer or their insurance company, you have the right to seek legal assistance to appeal the decision. Berry, Smith & Bartell, a Professional Law Corporation has helped numerous clients with their workers’ compensation claims throughout California’s central valley. With offices based in Santa Maria, Fresno, and Bakersfield, we have a location close by to serve nearly every Central California location. We have over 120 years of combined legal practice experience that we can put to work for you to help fight for your legally-entitled compensation in the most optimal and effective fashion.Call Berry, Smith & Bartell, a Professional Law Corporation at (888) 298-6753 or contact us online today and schedule your free initial case evaluation today.