It’s frustrating when you file a workers’ compensation claim and find things moving much slower than you expected. Many people in Los Angeles who are hurt at work hit the same roadblocks, and delays across the system are somewhat common. Knowing why these claims get delayed can give you an idea of what you need to do to combat this problem and allows you to build the strongest possible claim.
Common Reasons Work Injury Claims Get Delayed in Los Angeles
A wide range of issues can set a workers’ comp claim back in Los Angeles County. Here are some of the most common reasons a claim gets delayed: Late Reporting of the Injury
Workers’ compensation rules in California require that you report your injury within a set period, generally 30 days.
Except as provided by sections 5402 and 5403, no claim to recover compensation under this division shall be maintained unless within thirty days after the occurrence of the injury which is claimed to have caused the disability or death, there is served upon the employer notice in writing, signed by the person injured or someone in his behalf, or in case of the death of the person injured, by a dependent or someone in the dependent’s behalf.
If your supervisor or employer isn’t notified on time, the entire claim can be delayed or even denied.
Disputes About Whether the Injury Is Work-Related
Employers and insurance carriers sometimes argue that your injury or illness didn’t happen at work. If they think an injury actually happened during personal time or wasn’t actually connected to your duties, the process stalls while they gather more information or push back against approval. Reach out to our experienced work injury attorney today to learn whether or not your injury is work-related.
Incomplete or Incorrect Paperwork
The initial claim form (known as the DWC-1) must have all required information, but if things are left blank, typed wrong, or signed in the wrong place, your claim gets held up while clerks or insurance companies ask for corrections. Even honest mistakes will slow you down. Double-checking before submission can speed things up.
Waiting for Medical Evidence
Doctor’s reports and diagnostics (like x-rays or specialist notes) are the most important part of your claim. However, sometimes, these documents can be difficult to get. If clinics are slow to send paperwork, or additional reports are asked for by the insurance company, you can find yourself waiting weeks or months for your claim to get approved.
Insurance Company Investigations
Insurance companies rarely take claims at face value. An investigation may be started to verify the details, speak with witnesses, and review company safety procedures. This inevitably makes the claims process a drawn out situation.
Pre-Existing Condition Arguments
When you already had an injury of some sort, like prior surgery or another old injury, it’s not unusual for insurance companies to question if your injury is new and came from work, or if it’s just something you were already dealing with. More documentation, statements from doctors, and extra examination might be required, which can significantly slow things down.
What You Can Do to Avoid or Reduce Delays
While some delays are out of your control, there are steps you can take to keep your claim moving and avoid unnecessary setbacks.
- Report Your Injury: One of the most helpful things is to report your injury to your supervisor or employer as soon as possible.
- Complete Forms Accurately: When filling out claim or medical forms, review every answer for accuracy and leave nothing blank; even small mistakes or missing details can slow things down.
- Go To All Doctor’s Appointments: Always make it a point to attend every scheduled medical appointment, as failing to show up or follow up can give the insurance company a reason to argue that you’re not hurt, or your case isn’t serious.
- Save Important Documentation and Communications: Save copies of everything, like medical records, emails with your employer, and any official claim paperwork, so you can prove steps were taken properly.
- Follow All Directions From Doctors: Finally, follow all directions from your treating doctor, including rest instructions or referrals to specialists, since ignoring your plan might lead to disputes with insurance.
If your claim is delayed or the process becomes overwhelming, reach out to our office. We know how to handle these situations and will do what we can to speed up the process. Call today to schedule your free case evaluation with our Los Angeles workplace accident lawyer.