California Workers’ Compensation – the Appeal process

The Workers’ Compensation program in California protects workers who are injured on the job. This law partially replaces lost wages and provides the necessary medical treatment to recover from a work-related illness or injury.

Has Your Application Been Denied?

Sometimes a worker’s application is denied by the claims administrator. The reason for the denial may be that the injury was not work-related, or the injury was not severe enough to require medical treatment or time off work.

If you have received a denial letter, you have the right to appeal this decision and you need to act as soon as possible. At this point, it’s important to discuss your case with an attorney experienced in the appeal process for a better chance at a favorable outcome.

To submit your appeal request, you must visit one of the 24 California Workers’ Compensation Division offices and file an Application for Adjudication of Claim in either the county where you were injured or the county in which you live.

At the Hearing

You and your attorney as well as the claims administrator for your employer will be present at the hearing. The judge will decide whether or not the insurance company must accept your claim and will assist all parties in reaching a settlement. If no settlement is reached, the judge will schedule a date for a trial which will be presided over by a second judge.

You must attend the trial along with any witnesses that you may ask to testify on your behalf. Within 90 days after the trial you will receive written notice of the judge’s decision by mail. If you disagree with the judge’s decision, you may file a Petition for Reconsideration.

What about Medical Treatment while My Case Is Being Appealed?

Because your illness or injury is serious enough to keep you out of work, it’s important that you continue receiving medical care even if your Workers’ Compensation case is not yet settled.

Under California law, it is illegal for a medical provider to bill an employee for injuries that require immediate attention if they know the illness or injury may be work–related. This is true even during the appeal period.

How to Get Medical Care when Your Workers’ Compensation Claim is Denied

A serious job-related accident can occur at any Los Angeles workplace. If you are hurt on the job, it is your right to seek financial compensation for your medical bills and for a portion of the wages lost as you are recovering from your injuries. Ideally, your employer will help you secure the support you need in a timely manner so that you won’t have to worry about the ever-growing pile of medical bills.

However, it is relatively common for insurance companies and employers to reject legitimate claims and for injured workers to wonder how they will make a full recovery without going bankrupt. Do not give up if your workers’ compensation claim is denied. Instead, take action right away to get the support and compensation you need.

Under California’s workers’ compensation laws, benefits should cover any injury or illness due to a work-related accident. This includes accidents that occur while an employee is at work or when an employee is performing duties related to work. Injured employees are entitled to benefits as long as they can demonstrate that they were hurt because of work. Click here to read more.

America’s Real Treasure: Our National Park System

Here in the U.S. we are fortunate that our national leaders had the foresight to set aside some of the most beautiful and diverse ecosystems in the world, including stunning landscapes and wildlife from bears to falcons and whales.

It takes an act of Congress to create a national park, and they have done it only 59 times. Our own state boasts the most, with 9. Here are a few fascinating facts about these national treasures:

  • First: Yellowstone in Wyoming, Montana and Idaho was established in 1872 by President Grant and had the U.S. Cavalry as its first caretaker.
  • Most Recent: Pinnacles, about a 90–minute drive south of San Jose, was created in 2013.
  • Largest: Wrangell-St. Elias in Alaska covers more than 8 million acres – larger than Switzerland.
  • Smallest: Hot Springs, Arkansas at less than 6,000 acres is the only national park in an urban area.
  • Most Visited: in 2011 more than 9 million visitors enjoyed the Great Smoky Mountains in North Carolina and Tennessee.
  • Quietest: Alaska’s rugged and remote Lake Clark hosted only 5,500 visitors in 2011.
  • Highest: at 20,320 feet, Mount McKinley in Denali National Park, Alaska is the highest point in North America.
  • Lowest: Badwater Basin in Death Valley, CA is the lowest point in the Western Hemisphere – 282 feet below sea level.
  • Most expensive? Each park has the same daily entrance fee and you can save money with 7–day or annual passes, with more discounts for senior citizens and those with disabilities. So throw the kids in the car this summer along with a picnic lunch and explore America’s wild places.

If you or a loved one has been denied Worker’s Compensation or Social Security Disability (SSDI) benefits, it’s important to get an attorney experienced in these types of cases involved immediately. Call 800-438-7734 for your initial free consultation, either in our office or in the comfort of your own home. The Kenton Koszdin Law Office, Social Security attorney in Van Nuys, can help you navigate the application process for the best possible outcome for you and your family.

Recipe of the Month: Corn and Avocado Salsa


This tasty salsa is great with tortilla chips or served with grilled chicken.

Ingredients

  • 3 ears fresh corn, husks and silks removed
  • 2 avocados – peeled, pitted, and cubed
  • 1 red onion, finely diced
  • 1 red bell pepper, seeded and diced
  • 1 tablespoon minced garlic
  • 1 tablespoon ground cumin
  • 1 teaspoon crushed red pepper flakes
  • 1/4 cup chopped fresh cilantro
  • 1/3 cup red wine vinegar
  • 2 tablespoons olive oil
  • 1/4 cup fresh lime juice
  • salt and black pepper to taste

Directions:

  1. Place the corn in a large pot with enough water to cover, and bring to a boil. Cook until kernels are tender but crisp, about 5 minutes. Drain, and cool in cold water. Use a knife to scrape kernels from the cobs.
  2. Place kernels in a medium bowl. Stir in avocados, red onion, bell pepper, and garlic. Add cumin, red pepper flakes, and oregano. Mix in vinegar, olive oil, and lime juice. Season with salt and pepper.

What’s Happening in Southern California

May 1 – 4, 2015

50 Mile Urban Adventure Trek
Oceanside Harbor, San Diego

May 1 – 10, 2015

Movers for Moms collection drive
9245 Farnham Street, San Diego

May 1 – 20, 2015

In the Zone: Black & White Photography Exhibition
1650 Gallery, LA

May 1 – 31, 2015

Motown The Musical
Hollywood Pantages, Hollywood

May 6 – 8, 2015

World Tea Expo
Long Beach Convention Center, Long Beach

May 7, 2015

2015 Tinker Bell Half Marathon Weekend
Disneyland Resort, Anaheim

May 8, 2015

Wine Tasting with Master Sommelier Peter Neptune Zeytoon Café, Laguna Beach

May 9 – 10, 2015

Echo Park Craft Fair
Mack Sennett Studios, LA

May 17, 2015

Taste of the Nation food fest
Montage, Laguna Beach

May 17, 2015

Beach Blast 5k, 10k, 15k, Half Marathon
2000 Ocean Ave, Santa Monica

May 30, 2015

The Magnificent Marathon, Half & 10k Warner Ave & PCH, Hungtington Beach

May 30, 2015

Tony Bennett & Lady Gaga
Hollywood Bowl, Hollywood

May 30, 2015

Balboa Island Spring Wine Walk
Balboa Island, Marine Avenue, Newport Beach

May 31, 2015

Rock n Roll San Diego Marathon & Half Marathon
Intersection 6th Ave & Quince Street, Balboa Park, San Diego

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