(619) 768-2865San Diego Denial of Benefits Attorneys
Helping Clients Seek Death and Disability Benefits with Compassionate Legal Representation
Have you been denied Social Security disability, workers’ compensation, or death benefits even though you had a valid claim? Workers’ compensation, death benefit, and Social Security disability claims represent vital opportunities for individuals and families to obtain financial assistance and services. It is regrettable when the Social Security Administration or other agencies and companies issue a denial and decline to provide benefits for the disabled, the grieving, and the seriously injured.
The core principle of disability insurance claims and death benefit claims is to provide policyholders with financial support while the claimants go through some of their lives’ most difficult chapters. The claims process can be complex, and it is not always simple to determine insurance coverage. In some cases, the initial application may be denied, causing unnecessary emotional stress and leaving many applicants believing that they will be unable to recover the benefits they require.
If you have difficulty obtaining the benefits you deserve, our Southern California Law Offices would be honored to lend legal assistance. The experienced attorneys of our compassionate legal team can assist you through all steps of the claims process, including representing you in court as your trial attorney and making Social Security disability appeals if necessary. Please contact our San Diego-based law office today to learn more about how our denial of benefits attorneys can assist you.
Why Are Death Benefit Claims Denied?
Dealing with denied claims can be a stressful and confusing experience. It is often a result of small oversights that can lead to a denial under California law.
Some common reasons include the following:
- Not reporting the injury to the employer immediately
- Missing a deadline for filing a workers’ compensation claim
- Discrepancies between the accident report and medical evidence
- Filing a claim after being fired or laid off
- Refusing to cooperate with the workers’ comp insurer
Other challenges that can arise in obtaining death benefits include documentation issues, such as improperly submitting documentation or incomplete documents; legal disputes over dependency, where the insurance company may challenge the claimant’s status as a dependent; and the lengthy appeals process, which can be complicated, especially without experienced legal representation.
Our denial of benefits lawyers will proudly lend valuable legal guidance throughout the entire process, from the initial filing of your application through necessary appeals. We will advocate for our clients and their families to ensure that their legal rights are defended and that they are always aware of the benefits they are entitled to. We will handle negotiations with the insurance companies to secure the most satisfactory resolution and help you get paid faster. If we still face issues with denied claims, our attorneys can assist you throughout appeals by providing valuable evidence and documentation to support your claims.
Can Small Oversights Lead to a Workers’ Compensation Claim Denial?
Make no mistake, your employer’s insurance company will look for any excuse to deny your workers’ compensation claim, which means even the most minor oversight can lead to a workers’ comp claim denial if it’s a valid reason under California law.
Some of the most common reasons workers’ comp benefits are denied include the following:
- You didn’t report your injury to your employer right away
- You missed a deadline for filing your workers’ compensation claim
- Your injury wasn’t witnessed by anyone else in your workplace
- There is a discrepancy between your accident report and your medical records
- You filed your workers’ compensation claim after you were fired or laid off
- You refused to give the workers’ comp insurer a recorded statement or refused to sign medical authorizations
Being denied workers’ compensation benefits can leave most people feeling defeated. But you still can appeal and seek reconsideration. After filing a motion for reconsideration, the California Workers’ Compensation Appeals Board will decide. Typically, their decisions come down to either a confirmation of the denial of the petition, a dismissal of the petition, and reconsideration for further proceedings, or reconsideration with a new decision. Whatever the appeals council decides, you want experienced legal representation in your corner to assist you during these complex administrative hearings and procedures.
Have You Been Denied Social Security Disability Benefits?
If you were denied SSD benefits in Southern California, it’s important to remember that not all hope is lost. Our Social Security disability attorneys have legal experience and know-how to assist you in fighting back against denied claims and reapplying or appealing those denials.
An experienced disability attorney will consider different avenues to appeal your denied claim, including requesting a reconsideration, seeking a hearing before an administrative law judge, requesting a review with the appeals council, and petitioning the Federal Court of Appeals.
Typically, if your Social Security disability insurance or Social Security income benefits were denied, it was either for medical reasons or non-medical reasons. The most common medical reason is that the Social Security Administration believes that the severity of your medical condition or the duration of your disability does not rise to the level of requiring temporary or permanent disability benefits. Non-medical reasons for denials of benefits may include questions about whether you are eligible for those benefits because of income, taxes, or assets.
Are Denials and Delays Examples of Bad Faith on the Part of the Insurance Company?
Some, though not all, benefit denials may constitute acts of bad faith. While many claim denials are likely to be legitimate, insurance companies may consider ways to save money and cut corners if they can find evidence supporting the decision to deny a claim.
As your denial of Benefits lawyers, we will explore all possibilities for why your claims were denied, including raising the question of bad faith insurance tactics.
While our first belief may be to trust that the insurance company has legitimate reasons for denying a claim, if their disputes and challenges seem to change frequently or if the reasons for the denial seem increasingly implausible over time, it may be a case of bad faith insurance.
What Are Different Bad Faith Tactics Used to Deny Death Benefits and Disability Insurance?
Suspicious insurance company activity that may suggest bad faith tactics is in play includes examples such as the following:
- The insurance company fails to inform policyholders of insurance policy limits and other pertinent information
- The company underpays on insurance claims without providing an adequate explanation
- The insurer coerces claimants into making statements that can be misconstrued and used to support denials
- An insurance company makes unreasonable requests or demands for additional evidence from the claimant
- The insurance company fails to conduct an independent, thorough investigation into the claim for benefits
The Importance of Health Insurance in Workers’ Compensation
When a death benefits claim is denied, it’s essential to understand how your insurance plan, especially the health insurer, plays a role. It’s often the case that an employer’s insurance company looks for excuses to deny the claim.
Understanding Your Health Plan
Your health plan may have specific requirements and procedures for claiming workers’ compensation benefits. Understanding these requirements and working within them ensures affordable care and minimizes the risk of denial.
Internal Appeal Process
If your claim is denied, you may pursue an internal appeal. This involves reviewing your claim with the insurance provider to correct any mistakes or provide additional information that may change the decision. Understanding how to navigate this process is vital to overturning denials of claims.
External Review and Medical Necessity
Sometimes, you may request an external review by an independent third party. This review often focuses on medical necessity, ensuring that the claim is valid and required. An external review can overturn a denied claim if it is in your favor.
Can Our Legal Team Assist You with Denied Death or Disability Claims?
Dealing with denied claims can be complex and frustrating. Having experienced legal guidance can significantly improve the outcome.
Our San Diego Attorneys: Highly Skilled and Experienced in Denied Claims
Our team has years of experience in handling denied workers’ comp claims, including death benefits. We understand the nuances of internal appeal, external review, and working with your health insurer. We are committed to helping you navigate these complex processes to achieve the best possible outcome.
Avoid Setbacks and Pitfalls
With our assistance, you can avoid common mistakes that lead to denials, ensuring that your claim is handled accurately and efficiently. Our experience with denied claims and our understanding of the insurance plan and health plan requirements mean we’re perfectly positioned to help you.
Schedule a Case Evaluation with Our San Diego Denial of Benefits Lawyers Today
If you have been denied benefits and believe you deserve better, contact our Southern California law firm to discuss your case in more detail. Our disability attorneys can assist you with denied claims for Social Security benefits, our wrongful death attorneys can help you through the appeals process if death benefits were denied, and our workers’ compensation legal team can fight to make sure you get the settlement you require for medical expenses, lost wages, and other losses.
It’s natural to feel overwhelmed and maybe perhaps a little defeated when the insurance company or the United States government denies your request for benefits, but you must remember that this is not the end of the road. There are many potential routes to take to appeal decisions or ask for reconsiderations and potentially secure the fine potential recovery you deserve and require.
Our legal team has served clients in San Diego County, Riverside County, Orange County, and Los Angeles County for over 30 years, making us vital legal aids to our community and neighbors. We are proud of our commitment to assisting clients through the complexities of different practice areas and would like to help you with your legal issues.
If you have faced a denial of death benefits, don’t navigate this complex process alone. Contact us at (619) 768-2865 or via WhatsApp, and let us guide you through every step.
