What Can I Do if My California Workers’ Compensation Benefits Are Reduced or Terminated?

At Hanning & Sacchetto, LLP, our experienced workers’ compensation attorneys in Whittier know California workers’ compensation benefits are an essential safety net for employees who get injured or become ill while on the job.

These benefits can provide financial assistance for medical expenses, lost wages, and other related costs. Unfortunately, the benefits may be terminated or reduced in some cases, leaving the employee in a difficult situation.

What are the Most Common Reasons for Reducing or Terminating Workers’ Compensation Benefits in California?

There are several reasons why workers’ compensation benefits in California may be terminated or reduced.

Although not an exhaustive list, some of the most common include:

• Non-Work-Related Reasons

If it is determined that your injury or illness is not work-related, your benefits may be terminated. This may occur if it is found that your injury or illness was caused by a pre-existing condition or an activity that was not related to your job.

• Failure to Attend Medical Appointments

Your benefits may be terminated if you fail to attend scheduled medical appointments. Attending medical appointments is necessary to monitor your recovery and ensure that you are receiving appropriate treatment.

• Refusal to Participate in Treatment

If you refuse to participate in medical treatment your doctor recommends, your benefits may be terminated. This is because the treatment is necessary for your recovery, and without it, you may not be able to return to work.

• Medical Improvement

Your benefits may be terminated if a doctor determines that you have recovered from your injury or illness and can return to work. Workers’ compensation benefits are intended to provide financial assistance while you cannot work.

• You Returned to Work

If you return to work, your benefits may be terminated or reduced. Your benefits will depend on your earnings and how much you can work.

What Can I Do If My California Workers’ Compensation Benefits Are Reduced or Terminated?

If you believe your workers’ compensation benefits were reduced or terminated without cause, carefully review the decision. You must be notified of the decision before your benefits change.

If you disagree with the decision, contact your employer or the insurance company that provides your workers’ compensation coverage. Ask for an explanation of the decision and provide any information or documentation that may support your claim.

If you believe the decision to terminate or reduce your benefits was based on incomplete or incorrect information, you may request a re-evaluation. This may involve submitting additional medical evidence or requesting a second opinion from another doctor.

You may file an appeal if your benefits are still terminated or reduced after a re-evaluation.

You must follow the formal appeals process, which involves submitting a written request for review and attending a hearing before an administrative law judge.

If you have difficulty understanding how and why your benefits have been reduced or terminated, are having trouble navigating the appeals process, or believe your rights are being violated, contact our skilled workers’ compensation attorneys in California at (562) 698-6446 to schedule a free consultation.

We can help you understand your complete rights to your workers’ compensation benefits and represent you during the appeals process so you have the legal guidance to make informed decisions about your next steps. Contact us today to learn more.