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  1. #1
    Join Date
    Jul 2018
    Posts
    115

    Default How to Appeal a Second Workers' Comp Denial

    My question involves workers compensation law for the state of: ca

    After 11 months of appealing my claim, they sent me an accepted letter. A few days later I received a denial letter. The reason they gave was that benefits is denied for termination for cause. Theyíve known of this and has used this excuse from the beginning of my injury.

    Thereís no medical or legal evidence to support the reason they are denying it. It just says to contact the adjuster if I dont agree.

    How do I appeal this?

  2. #2
    Join Date
    Sep 2005
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    Default Re: How to Appeal a Second Workers' Comp Denial

    If you have not exhausted all of your administrative appeals, you will need to continue to appeal within the agency. Typically instructions are given along with the notice of denial.

    If you have exhausted all of your administrative appeals, you can consider filing a lawsuit in court. For that, it is highly advisable to get help from a lawyer.

  3. #3
    Join Date
    Jul 2018
    Posts
    115

    Default Re: How to Appeal a Second Workers' Comp Denial

    Quote Quoting Mr. Knowitall
    View Post
    If you have not exhausted all of your administrative appeals, you will need to continue to appeal within the agency. Typically instructions are given along with the notice of denial.

    If you have exhausted all of your administrative appeals, you can consider filing a lawsuit in court. For that, it is highly advisable to get help from a lawyer.

    It doesnít say anything about appeal. All it says is if I disagree then I can call the adjuster.

    I Thought they needed new evidence if they want to deny after 90 days of the injury. They have known and have told me many times this was the reason my claim was denied and they refused to pay any benefits.

    The judge told me that my termination doesnít effect ttd because itís a medical issue that a doctor has to address. Iíve been told that the judge has been replaced so Iím not sure what to do.

    I had my second qme yesterday but Iím worried the insurance carrier will not go by his report.

    I should be in a better position to get representation once the reports comes out. I have a feeling this denial letter is an attempt to scare me into settling.

    How should I look for when looking for an attorney with the report?

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