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How Can I Obtain Medical Care If My Workers’ Compensation Claim Is Denied?

If you have sustained a workplace injury or illness, chances are you have a number of worries and questions, including how you might afford the medical care you need and how long it might take to make a full recovery, if ever.  In California, most employees and workers are entitled to receive workers’ compensation benefits if they are injured or suffer an illness that is work-related.  The purpose of workers’ compensation benefits is to help mitigate the financial burdens associated with missing work, having a temporary or permanent disability, and other losses.  If an injury or illness is truly work-related, such as an accident that happens when a worker is performing their job duties, injuries are stress-induced from a work situation, or injuries are associated with exposure to dangerous chemicals or substances or repetitive motions, workers’ compensation must also cover medical treatment.  While these benefits can really help injured workers, not all employers or insurance companies find an injured worker’s claim to be legitimate.  When this occurs, an injured or ill worker might end up foregoing expensive treatment that is necessary and essential.

If your injury or illness requires immediate medical attention, you should seek the treatment you need.  Generally, a doctor or other health care provider cannot bill you if your injuries or other damages might be work-related, though they may ask you to sign a lien form that states that they will wait for payment for their services until after your claim is settled.  There are some exceptions to the kinds of injuries that workers’ compensation will cover, but usually, if you can establish that your injury or illness is work-related, you will likely be entitled to receive medical benefits.  If you were injured on the job and are in need of medical care, but your workers’ compensation claim has been denied, it is important that you consult with an experienced California Workers’ Compensation Lawyer as soon as possible.  A skilled workers’ compensation lawyer can help you contest the denial of your workers’ compensation claim by filing what is called an adjudication of claim with the state’s Division of Workers’ Compensation.  Having an experienced and dedicated lawyer on your side will help to expedite the process and will increase your chances for a successful outcome.

It is important to note that in most instances, injured workers must seek treatment from doctors or health care providers that are members of the employer’s or the insurance company’s medical provider network.  But if your claim is denied or if you were not provided with medical treatment in a timely manner after you suffered your injury or illness, you may be able to seek treatment outside of the medical provider network.  Even if your claim is admitted or allowed, there might be some instances where you can seek treatment outside of the network.

Experienced Workers’ Compensation Lawyer in California

If you or someone you know has been injured or has suffered an injury as a result of a work-related accident or incident, especially if the accident happened in the Hemet, San Bernardino, or Inland Empire areas, you might be eligible to receive to workers’ compensation benefits under California’s workers’ compensation law.  Albert E. Hirst, III, has extensive experience dealing with the claims of injured workers and he has the knowledge and resources necessary to help you obtain the workers’ compensation benefits you deserve.  Call our office today at (909) 885-7190 to schedule your free initial consultation and find out what we can do to help you.