What to do when your Employer Refuses to Provide Claim Form or Treatment Once you Report a Work Injury

While nobody wants to sustain an injury on the job, workplace injuries often happen across California every day. The good news is that the workers’ compensation system in California is designed to provide workers in California with suitable insurance protection when they get injured or hurt at work. However, sometimes, your employer may not acknowledge your workers’ comp claim. This is where attorneys in the Bay Area workers compensation field can be immensely helpful.

Suppose you have been injured at work and your doctor says you cannot work. You have to file a claim for workers’ compensation benefits in California, and you need relevant forms and certain information in order to do so. Your California-based employer, unfortunately, is refusing to provide you with the claim form and information you need. Alternatively, you may feel that your body has broken down over a period of time due to work but your employer tells you it is not work related. In this situation, you must help yourself by getting the proper help to protect your rights.

While the California Workers’ Comp Law requires that this type of information should be readily available, many employers in the state simply ignore these important requirements or are uncooperative. There could be multiple reasons behind your employer’s refusal to cooperate. However, workers compensation attorneys in the Bay Area can help get you the comp you need.

Also, if you have been injured at work, filed a workers’ comp claim in California, only to realize that your employer is fighting your efforts to get compensation benefits, you have come to the right place and your employer can be in for a slew of consequences. A goodwork injury lawyer in the Bay Area can help you in this regard.

In an ideal world, when an injury or incident occurs, it is immediately reported for workers’ comp. However, at times, your employer may not provide you with the claim form, not report your injury, or refuse to provide treatment for your injuries. As compensation claims in California are very time-sensitive, any delays in reporting can create serious problems. If your employee is trying to attempt something unlawful, we will let you know what steps you have to take to protect your rights.

Common Issues in Worker’s Compensation Claims

Note that whether your employer pays for workers’ comp insurance or is self-insured for workers claims (meaning that your employer sets aside funds for covering the costs of workers’ injuries), they may decide to fight your compensation claim for a variety of different reasons. If your employer contends they have a valid defense (and in many cases, even if they do not), you might face an uphill battle in claiming the benefits for your workplace injury in California. Find a good San Francisco workers complawyer to help you. 

Another common issue that you may face is that your employer may mishandle or mismanage your employees’ claims. This is especially true in the initial stages of your compensation claim, as you need the cooperation of your employer. Keep in mind that delays or mistakes in processing workers’ comp claims in California can put you at a disadvantage – and also put your health and well being at risk.

Why your Employer may Deny Workers’ Compensation?

Some insurance companies in the state like to deny workplace injury claims all the time. Sometimes, they do it for a valid reason and most of the time simply because the insurance providers are hoping injured employees will just take their word for it. Here are some reasons your employer may deny your comp claim.

Failure to Give Notice

Workers’ compensation insurers in most states do not like cases where the injury or accident does not get reported immediately. Injured employees have to provide timely notice to their employer when they sustain a work-related injury. If you do not report your illness or injury within this required period of time, your employer might be able to deny your comp claim.

Your Work Injury was Unwitnessed

This could be another reason. Workers’ compensation insurers do not like unwitnessed injuries, which is understandable. If you get injured at work and nobody saw your accident, there’s not much that you can do about it. However, you should definitely make sure to report your work injury to your supervisor and co-workers immediately, and you should tell everyone the same thing about how the injury occurred. Being consistent is very important.

Some other reasons your employer may deny your claim are:

  • Statute of limitations
  • There’s a discrepancy between the initial medical records and your accident report
  • Your preliminary medical records show the presence of any illegal drugs or substance in your system
  • You refused to sign medical authorizations or refused to give the insurance provider a recorded statement.

Steps to Take when your Employer is Uncooperative 

If you’re injured on your job, you have the legal right to receive adequate medical treatment and to have that medical treatment covered by California workers’ compensation even in case your employer refuses to acknowledge your injury, does not provide the form, or tries to dissuade you from reporting it.

Regardless of what your employer does or says, your priority in an emergency situation should be to get medical treatment. So, if you need urgent medical treatment, do not wait to go to urgent care, the ER or the doctor because you think you have to report the injury first.

If your employer is refusing to provide you with a claim form or not providing the medical treatment you deserve, another step is to take it up with the human resources department in your company. Note that if there was an internal mistake, all you may have to do is bring it to your company’s attention for the issue to be resolved.

Unfortunately, only saying that “my employer didn’t report my work injury” will not be enough.

So, if your employer failed to file a workers’ compensation form or has not provided you one, you should also get in touch immediately with the California Workers Compensation Board. The board will guide you through the process of filing all the correct forms. Generally, the board will ask you to file a form called DWC 1, which will help in the process of seeking your compensation. Finally, you can work with a San Francisco worker’s compensation lawyer to make the process easier.

In addition to filing this claim form, getting in touch with aworkers’ comp attorney in San Francisco when you know your employer didn’t report your work injury will help you in making sure that you are covered. And if your California-based employer is refusing to send you for medical treatment, you may use your personal health insurance in order to get treatment at your doctor. It is worth mentioning that workers’ compensation insurance in California can reimburse you as well as your health insurance later. You have another option as well. There are many clinics in California that will treat uninsured patients. 

Also, it is important to keep track of your mileage both to and from your medical appointments. This is because you are entitled to reimbursement for expenses if you drive your car more than twenty miles roundtrip in order to receive treatment. In this case, make sure that you tell your doctor that your injury occurred at work. Also, provide your physician with your employer’s name, address and contact information. It is worth noting that medical records which document the way you were injured at your workplace can serve as important evidence when your employer has refused to provide treatment.

Also, make sure that you follow your doctor’s advice.

If your doctor recommends time off work, make sure they include a note to that effect in your records. And in case your doctor suggests a couple of follow-up appointments or refers you to another specialist, make sure that you continue your treatment plan so that you do not jeopardize your workers’ comp claim in California.

As your California workers’ compensation claim and treatment progress, you will be asked to fill out lots of paperwork and complete and sign lots of forms. Keep in mind that all of this paperwork could have a bearing on your case. You should not submit or sign any form or paperwork without completely understanding it.

Fighting Back When Your Employer Refuses to Pay Workers’ Compensation Benefits

Fortunately, California law requires all employers to cooperate with their employees, and if they do not, injured workers can take legal action in order to enforce their rights. Hence, if you sense or have reason to believe that your employer is trying to cause problems for you – or if they simply do not give you what you need, such as your claim form – you must seek legal help as soon as possible to protect yourself. 

In most cases, the sooner you get aSan Francisco or Bay Are worker’s compensation attorneyinvolved, the sooner you’ll be able to get all the benefits you need and deserve.

Contact Us

At the law offices of West Coast Workers Comp Attorney, we concentrate our legal practice in the area of workers’ compensation law in California, and we have more than 15 years of experience in this field. You can call us at 415-218-5634at any time for a free consultation.

The information provided on this website does not, and is not intended to, constitute legal advice; instead, all information, content, and materials available on this site are for general informational purposes only.  Information on this website may not constitute the most up-to-date legal or other information.