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Delayed Workers’ Compensation Claim

Delayed Workers’ Compensation Claim

If you have received a delay notification for a workers’ compensation claim, you are not alone.

The U.S. Department of Labor reports that injured or ill employees in California filed over 14,000 workers’ comp claims in 2023. Approximately 7,000 of these claims were ultimately settled. 5700 claims are currently denied. 1300 claims are currently delayed. There is no record available. But, many of these claims that have settled or denied were once delayed.

Receiving a delay notification on workers’ comp benefits claim is irritating. But, delays occur as work injury claims are easily subject to complications. Yet, nothing should hinder anyone suffering from a work injury or illness. A complete and speedy recovery is only fair.

Helpful information and recommended actions that focus on your delayed claim is available here.

Table of Contents

Why Do Workers' Compensation Claims Get Delayed?

Workers’ comp claims are complicated. Various areas are or become difficult. In California, some of the most common explanations are:

Shortage of Qualified Medical Evaluators (QMEs)
The lack of QMEs delays timely medical evaluations to establish injury and benefits.

Incomplete Documentation
Insufficient information stalls the claim as complete documentation is required.

Claim Dispute
More investigation is needed if there is dispute about the claim or injury.

Medical Treatment Disputes
Disagreements over the necessity or appropriate care stalls the claim process.

Administrative Mistakes
Errors in paperwork or communication errors creates delay.

Delay Tactics
Workers’ comp insurance companies use delay tactics to cut claims. They do this to avoid paying.

Changing Regulations and Policies
Any policy change can create confusion and interrupt the claim.

Backlog of Claims
The workers’ comp board and insurance companies face work backlogs.

Your employer or their insurance company may need extra time in good faith to work on the claim. But, extended delay without notice can signal a need for answers.

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If Your Workers' Comp Claim is Delayed, What Do You Do?

Take the following actions. They are the best steps to move forward and safeguard your claim.

Contact Your Employer
Speaking with your employer about the delay may prove beneficial. Ask why there’s been a hold-up.

Assemble All Documentation
Make sure all paperwork on your injury is correct and complete. Gather all medical records and accident reports. Collect any communication with your employer or their insurance company about your claim. Have this information ready.

Consult with a Work Injury Lawyer
Assistance is available through the services of a workers’ compensation attorney. Schedule an initial consultation for your delayed claim. They can help speed the process while facing any challenges. Seek the best lawyer for you and your case.

Thomas DeBenedetto is an experienced workers’ comp attorney in San Diego. Since 1992, his law firm has secured over 1 billion in benefits for injured workers. 

Thomas DeBenedetto & Associates - Workers' Compensation Attorney

Over 1 Billion in Benefits Recovered on the Behalf of Our Clients

Over 30 Years of Experience in Workers’ Compensation Claim Rights for the Injured

Pay No Fees If We Don’t Win

Immediate Medical Treatment for Your Injuries

Maximum Settlement & Benefits for Your Case

Free Same Day Case Evaluations

Denied & Delayed Cases Accepted

Stress & Psychological Cases Accepted

Frequently Asked Questions on Delayed Workers' Compensation Claim

The most common reason for delay is establishing injury. More Qualified Medical Examiners need to be hired to speed up the claims process.

An employer or workers’ compensation insurance company has up to 90 days to complete an investigation.

If notice has not been given within almost 3 months, the claim is accepted. You are eligible for benefits. This is usually referred to as the 90-Day Rule.

You should have a claim with the Employment Development Department (EDD) opened. If you need to take action file for state disability insurance (SDI). Filing online is the quickest way to start. File to protect your claim now.

Appeal. Employees suffering work-related injuries can apply with the Workers’ Compensation Appeals Board (WCAB).

Schedule an initial consultation with a workers’ comp attorney to discuss your options.

Thomas DeBenedetto • Since 1992

We Never Make Promises
We Can’t Deliver

Call Us Now To Schedule a Free Initial Consultation
with an Experienced, Ethical & Caring Workers'
Compensation Attorney in San Diego.

Remember, You Have Rights, Don’t Be a Victim!

Testimonials

Satisfied Clients Are Our #1 Priority

Had a heat stroke in August 2021 and it completely changed my life for the worst. Unfortunately, I was not receiving the medical care or attention I needed at the time so I had to retain an attorney. Once I did, things changed immediately. Thomas and his crew were on it from the start. They sent me to medical professionals that were able to actually help me. Teresa was my medical coordinator and ALWAYS got right back to me via text or by phone with any questions or concerns I had. She is awesome!!! The entire staff was amazing. The process was long but in the end I was happy with the result and I would definitely recommend Thomas and his firm to anyone injured on the job. Thanks again.

Joe S.

I got injured at work and went through workers comp. After a year of doing everything they requested of me and continuing to be in pain they told me they refused my surgery. The next day I hire Mr. Debenedetto and I am glad I did. They told me to stop seeing the worker comp dr and sent me to someone who actually cared. This Dr. listen to me and understood my pain. for the first time in over a year I was actually being heard. After seeing this Dr. twice, I was scheduled for surgery. I reached out to my legal team multiple times. They were always helpful and understanding. I appreciate Bianca. She really helped me with all my questions. It was definitely a long journey but I was happy to have them in my corner. I definitely would recommend them to anyone who is dealing with a worker comp claim!!! I would also say don't try and do it alone. Hire an attorney. Had I done that in the begin I don't believe I would be permanently disabled. I am so thankful for the people who helped me fight this case. I always felt like they were doing their best to make sure I was taken care of.

MJ

I am so grateful that I had their representation and help navigating the workman’s comp medical system. They fought to get me medical care that was not only a necessity, but was lifesaving. For years they stuck by my side and made sure that I was well taken care of. Every person on their team was such a valued asset, from getting me to the right doctors, getting me approved for treatments, and taking care of my overall wellbeing. I couldn’t have made it without them, I truly believe that. They literally saved my life.

Kristen H.

Get Help Today

Applying for workers’ compensation benefits is not a straight forward process. Paperwork, backlog, errors, and disputes can stall your claim.

Seek experienced legal representation. Ensure that you receive all benefits from your work injury or illness. Schedule a free consultation with Thomas DeBenedetto & Associates on your delayed workers’ comp claim today.