Workers' Comp. Claim Timeline: Accepted Vs. Denied

If you are injured or become ill at work, your immediate focus will be on receiving medical treatment and reporting your injuries to your employer. But what happens after that?

After completing these critical first steps, your path to receiving compensation will differ depending on if your employer, and their insurance company, accept or deny your claim. If your claim is denied, there will be several extra steps added to the process, because you’ll need to appeal your case in order to receive benefits. An accepted claim will move much more quickly.

Accepted Workers’ Compensation Claim Timeline

While many workers’ compensation claims are initially denied, it is possible that your claim will be approved if the circumstances surrounding your case are clear and irrefutable. If your claim is accepted, the process will largely focus on establishing the terms of your coverage plan. You will work with your employer and their insurance company to determine how much you will be paid, over what period of time, and other details.

The timeline for an accepted workers’ comp. claim will generally follow these steps:

1. Receive an assessment from your medical care provider, and begin gathering evidence

2. File a claim for benefits

3. Discuss terms with your employer and their insurance company

4. Reach an agreement

5. Begin receiving periodic payments or a settlement

6. If applicable, reach maximum medical improvement and return to work

Denied Workers’ Compensation Claim Timeline

If your workers’ comp. Claim is denied, the process of appealing your claim will be more drawn out, but highly worthwhile so you can recover the benefits you deserve. Rather than immediately launching into negotiating terms, you’ll need to work to get your claim accepted first.

The timeline for a denied workers’ comp. claim will generally follow these steps to appeal your case:

1. File an appeal request

2. Await approval from the state workers’ compensation board

3. Engage in mediation with your employer and their insurance company

4. Complete your hearing/trial

Regardless of what step your workers’ compensation claim is in, hiring a Certified Workers’ Compensation Specialist may be in your best interest. Whether you anticipate your claim being accepted or denied, our team at Cole, Fisher, Cole, O’Keefe + Mahoney is committed to helping throughout the process in order to recover the benefits you deserve.

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Cole, Fisher, Cole, O’Keefe + Mahoney is Central California’s leading workers’ compensation and social security disability law firm. With over 30 years of successful experience, we are committed to securing maximum benefits for our clients in the Fresno, California area. Schedule a free consultation today.