Why is My Workers’ Compensation Claim Delayed?
When you report a work-related injury to your employer, you initiate the process of obtaining WC benefits. The first and most important benefit is a referral to a workers’ compensation (WC) physician for medical treatment. If your WC treating doctor takes you off work while you are recovering from your injury (or provides temporary work restrictions that your employer cannot accommodate), you are eligible to receive temporary disability (TD) benefits equal to two-thirds of your gross (pre-tax) wages while you are off work. Being off work due to an injury can be stressful, and injured workers rely on access to WC treatment and TD benefits to meet their medical and financial needs.
Unfortunately, there are many times when a decision regarding a WC claim may be delayed, which can result in a delay of medical treatment and financial hardship for injured workers already struggling with medical bills and a loss of income. In those circumstances, it is important to understand all of your rights, including that Labor Code 5402(c) requires that the insurance company pay for up to $10,000 for medical treatment while the claim is on delay. And that if an injured worker has paid into EDD disability, they can apply for State Disability Benefits as a substitute for TD benefits while their claim is on delay.
What Can Cause a Delay in My Workers’ Compensation Case?
Understanding some of the common reasons for these delays may also enable an injured worker to help facilitate faster processing of their claim. Some of the common reasons why workers’ compensation claims might be delayed include:
- Lack of Medical Documentation to support the injury or illness.
- Failure to timely report an injury to your employer.
- Disputes regarding the cause of injury and whether it occurred at work.
- Incomplete claim forms and medical documentation
- Disagreements between your employer and their WC insurance carrier regarding liability.
Ford & Wallach is Your Guide
If your workers’ compensation claim is delayed, it’s advisable to communicate with your employer or their workers’ compensation insurer to inquire about the status of your claim and the reasons for any delays. Additionally, consulting with an experienced workers’ compensation attorney can be beneficial in helping you navigate the process. To learn more, contact us to schedule a free case evaluation with one of the experienced attorneys at Ford & Wallach.
To learn more, schedule a free case evaluation with one of our experienced attorneys. Contact us by email or call 213.380.3140.