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What to do if your medical benefits are denied

Enduring the stress of a workplace accident in California can become even worse if your medical benefits are denied. Bills that you thought would be covered may not be, threatening to cause you financial ruin. We at Koszdin, Fields, Sherry and Katz understand this dilemma and work to ensure that you get the help you deserve.


The Department of Industrial Relations details what to do if you find yourself in this scenario. First, it is important that you realize that you have the right to object to a denial. You can challenge the claims administrator’s decision to deny your claim, but you need to do so within a certain time frame. Talk with the department to find out what the deadline is for your case.


Another reason your claim may have been denied is that the administrator does not feel your injury qualifies for treatment. If this is the case, you can schedule an appointment to be evaluated by a qualified medical evaluator and resolve the dispute through an independent medical review.


You will also need to file a case against the denial of your claim. This can be done at any of the Department of Worker’s Compensation locations in the county where you live or where you were injured. You will then be assigned a case number and given a hearing, where you can use documents and information to prove your reasoning to the judge. To learn more about how to fight a medical benefit denial, visit our web page.

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