Workers who get hurt on the job in California expect to have protection from workers’ compensation benefits. However, some people will have an uphill battle when they apply for benefits because their employer challenges their claim.
One of the more common reasons that employers challenge a worker’s benefits claim is the assumption that the worker did not actually get hurt on the job. If you know that your injury is from your employment but your employer claims otherwise, how can you potentially get the benefits you need?
California has a rule for this exact situation
It is quite common for employers and their workers to disagree about the nature of an injury or an employee’s right to benefits. If your employer insists that your injury is not related to your job, you can ask for help from the state. The state certifies qualified medical evaluators (QMEs) to address medical issues in disputed workers’ compensation claims.
When there is a disagreement about the source of an injury to an employee, either the worker or their employer can request an evaluation. The state will provide the employee with a list of randomly selected QMEs. They can choose one and undergo an evaluation. If the drive is significant, the state does offer compensation for travel when necessary.
The QME will ask questions and perform physical tests to determine the likely origin of the injury. The report that they issue can potentially help the workers get benefits after a previous denial. Learning more about the ways that workers’ compensation helps employees that need benefits prove their cases could take some of the stress out of your application or appeal.