Fremont, CA asked in Workers' Compensation for California

Q: what steps do I need to take to have insurance carrier to pay benefits if my claim is now accepted.

My claim was denied but it is now accepted. It was accepted a year ago but they told me it’s denied. They have come up with numerous reasons as why I’m not being paid benefits for loss wages. They can never provide any reasons. They have all the doctor report but refuse to pay. They always back track to my termination for cause when they run out of excuses. I spoke to doi and they told me it has no effects on my claim. They want me to take it up to the judge but why is it necessary if they have no reason to object. I have all the doctors report as ttd but they have ignored them.

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1 Lawyer Answer
Ronald Mahurin
Ronald Mahurin
Answered
  • Workers' Compensation Lawyer
  • Point Arena, CA
  • Licensed in California

A: The only recourse is to go to court and have the WCJ order them to pay. No matter what the status of the acceptance/denial, if the insurance company is not paying benefits and the medical records supports those benefits, you must seek court help. If you believe the lack of payment is in bad faith, then you can seek a penalty of up to 25% of the benefits denied up to $10,000.

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