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What Do I Do if My Benefits End or Are Denied
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What Do I Do If My Benefits End or Are Denied?

San Bernardino workers’ comp attorneys help injured workers in California secure benefits

At Invictus Law, P.C., our workers’ compensation lawyers assist injured workers throughout San Bernardino, Riverside and Orange counties — including Santa Ana, Irvine and Orange — successfully claim benefits through federal and state programs. We help you find the legal resolutions you need at affordable prices and provide you with the attention you deserve. Our legal team’s goal is to help you overcome obstacles.

What to do when benefits end

  1. Temporary disability benefits end when one of four events occur:
  2. The doctor who has been treating you says you are cleared to return to work.
  3. You return to your usual work or to alternative work at the same wages.
  4. Your condition is neither improving nor worsening, and therefore, becomes permanent and stationary.
  5. You have received up to 104 weeks of temporary disability benefits within five years of your injury. (Certain conditions may have warranted up to 240 weeks of temporary disability benefits).

You should receive notification that your benefits are ending from your claims administrator within 14 days of your final payment.

But this doesn’t necessarily mean the end of benefits. If your doctor states you can never completely recover, you may qualify for disability benefits for permanent disability or supplemental job displacement. Our workers’ compensation attorneys at Invictus Law, P.C. can review your unique situation and counsel you on the best next steps for your recovery.

What to do when benefits are denied

When you receive notification that your claim was denied, it means the claims administrator did not believe that workers’ compensation covers your injury. But take heart, because you can challenge the claims administrator’s decision by following these steps:

  1. File a case. The process of challenging the initial decision about your workers’ compensation benefits begins with filing a case at an office of the California Division of Workers’ Compensation (DWC).
  2. File an application for adjudication of claim. If you want a judge to hear your case, you must file an application for adjudication of your claim either in the county where you live or in the county where you sustained your injury. This application has to be served on all parties, including your claims administrator.
  3. Receive notification. The DWC sends you a notification, which includes your case number, that your application has been filed.
  4. Request a hearing. You must file yet another document, the declaration of readiness to proceed, to request a hearing before a judge. Your case’s hearing, called a mandatory settlement conference, is scheduled.
  5. Attend the hearing. You, the claims administrator, your attorney and the claims administrator’s attorney appear before the judge. If your case does not settle at this conference, you proceed to trial.
  6. Go to trial. You must prepare all necessary documentation for trial and you must attend. The judge delivers his or her written decision by mail. You should receive it between 30 and 90 days after the trial.
  7. Request reconsideration. If either you or the claims administrator disputes the judge’s decision, you can take an additional step and file a petition for reconsideration.

If you decide to have one of our qualified workers’ compensation attorneys represent you through this process, you receive both valuable assistance with filing, identifying and gathering pertinent documentation and advocacy at your hearing — and, if necessary, at trial. Our attorneys also guide you step-by-step through the process so you know what to expect. It may be your first time dealing with the DWC, but we have done this many times and can anticipate likely outcomes, taking new courses of action when needed.

Get the help you need with workers’ compensation benefits

If your benefits have ended or your initial claim for workers’ compensation benefits has been denied, reach out to Invictus Law, P.C. We have two convenient office locations in Santa Ana and Ontario, California, and we offer flexible hours for your free initial consultation. You can call us around the clock at (949) 287-5711 or contact us online to arrange your risk-free appointment. Our firm does not require you to pay any up-front attorney’s fees.

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