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How Workers’ Compensation Claim Denials May Backfire on the Insurance Company
Daniel Tan | June 2, 2025 | 0 Comments

How Workers’ Compensation Claim Denials May Backfire on the Insurance Company

Workers’ compensation claims are often not as easy as filing for benefits and receiving them.  The employer’s insurance company can, and frequently will, deny an employee’s claim for any one of a number of reasons.  For example, if they suspect that you have not been injured at all, or were injured away from work, they can delay a decision on your claim, or deny it altogether. If you have the bad luck to have been injured on a Monday, or on your first day back from a holiday or vacation, they may argue that you were injured away from the job and are now attempting to obtain benefits that you do not deserve.  The Riverside workers’ compensation lawyers at Heiting & Irwin fight for injured workers like you when there are issues with your claim.

The Insurance Company Does Not Get the Final Word

When an employer, usually through its insurance company, denies a workers’ compensation claim, the process is not over. California law allows employees injured on the job to appeal that denial to the Workers’ Compensation Appeals Board (WCAB) and seek all allowable benefits. They may be simply counting on you to go away quietly when they throw up an initial roadblock to your claim. Don’t be deterred.  You can, and should, fight for the workers’ compensation benefits you deserve.  To enhance your chances of obtaining those benefits, you should hire Heiting and Irwin to aggressively pursue your rights.

Richard Irwin is a workers’ compensation specialist, which means that he has completed all requirements and has the experience required by the State of California for such a designation.  Very few attorneys who appear before judges at the Workers’ Compensation Appeals Board attain this status, yet they typically ask for the same attorney fee as Mr. Irwin.

The Odds Are in Your Favor When You Appeal a Workers’ Compensation Denial

It is hard to quantify your particular chances of winning your workers’ comp appeal, should you need to file one. Everything depends on the facts and circumstances of your own case and whether you can prove that you suffered a work-related injury or disprove the version of the facts that the insurance company is telling. However, our experience with handling workers’ compensation claims shows that claimants, in general, have a far better track record than you may think after appealing a denial of their claim.

Some studies report that, overall, nearly 70% of workers’ compensation claim denials are converted to benefits in some way. In fact, it is our experience that at least four out of every five claimants who receive benefits after an initial denial have agreed to a settlement. In many cases, you will receive more money than you would have otherwise gotten even had the insurance company simply approved your initial claim for benefits.

When you hire Heiting & Irwin to represent your interests, you are hiring attorneys who work on a contingency basis, meaning that attorney fees are awarded only if the matter is resolved in your favor. Settlement and positive results are much more likely if you hire a respected attorney, such as Richard Irwin, to represent your interests. In fact, you may be able to minimize the chance that the insurance company will deny your claim if you retain a respected workers’ compensation attorney at the outset of your case.

Although working with an attorney does not automatically ensure that you would receive workers’ compensation benefits, it may result in a stronger claim presentation and show the insurance company that you will not be intimidated during the claims process.

Contact a Riverside Workers’ Compensation Law Firm Today

When the insurance company is giving you the runaround, enlist the workers’ compensation lawyers at Heiting & Irwin for our determined legal advocacy. The first step is to schedule an initial consultation with one of our workers’ compensation attorneys, and you can do that by filling out an online contact form, or by calling us today at 951-682-6400, or contact us at hilegalgroup.com. There is no fee to you unless you win your case.

Daniel Tan

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