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Having a medical benefits claim rejected can be devastating when you are facing a lengthy recovery from a workplace injury or illness. Without these benefits, and the ability to pay for the medical attention and treatment you need to recover, you may find it incredibly difficult get back on your feet and return to your job. Of course, if you have family and dependents relying on your income to survive, it quickly becomes an even more urgent problem. Your employer’s workers’ compensation scheme has been put in place to provide the benefits you need after an injury but, as these schemes are run by insurance companies, the insurers often choose to protect their own financial interests, thus denying what seems to be a perfectly valid claim.

There are certain conditions to satisfy before a claim for medical benefits can be approved but, when you have adhered to each of these only to have your claim rejected, a Santa Clarita medical benefits attorney from Koszdin, Fields, Sherry & Katz has the legal expertise required to appeal this decision.

Why Might My Medical Benefits Claim be Rejected?

One of the most common reasons for the insurers funding workers’ compensation schemes to reject claims is the length of time which has passed since the incident in question occurred. Under California law, you must report any workplace injury within 30 days, and file the resulting workers’ compensation claim for medical benefits within a maximum of one year, where the insurance company has not provided any of the benefits, and a maximum of five years where they have. If you leave too long between the time of sustaining your injury and filing your claim, the insurance company may become suspicious and treat your case as potentially being a false claim.

One of the top tips your expert Santa Clarita medical benefits attorney can offer is to file your claim as soon as possible, rather than waiting until close to the deadline. While this will not guarantee approval, it will at least remove one potential reason for being turned down and, thus, forced to appeal.

Some other common reasons why medical benefits tend to be denied include the following:

  • The insurer believing that the injury in question was, in fact, a pre-existing condition and, therefore, not eligible for benefits under a workers’ compensation scheme
  • The insurer may also believe that the injury occurred while you were off-site or not on-the clock, again invalidating your claim
  • If the injury or illness you have sustained is minor, the insurer may rule that it is not sufficient to qualify for such benefits

Whatever the reason behind rejecting your claim may be, our expert workers’ compensation attorneys could help appeal and reverse it.

Schedule Your Free Initial Consultation with a Santa Clarita Attorney Today

To discuss the details of your medical benefits claim with an outstanding and highly experienced lawyer, you need look no further than Koszdin, Fields, Sherry & Katz. Schedule your free initial consultation with our expert legal team by calling today at 800-747-3447.