Workers injured at their job sites are entitled to compensation under California’s workers’ compensation insurance program. This compensation should cover medical bills, lost wages, and other expenses that you’ve incurred as a result of your work-related injury. Sometimes, though, the checks don’t start coming when they should. If this happens to you, keep an eye out for these common reasons for delayed workers’ comp payments in California.
Administrative Delays
Some delays in the issuance of workers’ compensation checks stem from bureaucratic inefficiencies, such as slow claim handling. If the insurance company has a backlog of paperwork or the organization has insufficient staffing, it can delay the receipt of your check. Miscommunication between insurance companies, employers, and employees can also play a role.
Medical Delays
Other delays occur due to difficulty with obtaining necessary medical reports or scheduling essential exams. These delays can be particularly harmful because they can impact an injured worker’s ability to receive treatment on time. Even if you’ve stayed on top of coordinating between your various medical practitioners and ensured that all documentation is complete, waiting for specialist appointments can also slow the claims process.
Legal Delays
Disputes about whether an injury was actually caused at work can mean delays in the receipt of your workers’ compensation benefits. In some cases, the extent of the injury being questioned by the insurance company can also create delays. In both examples, lengthy legal proceedings are required to determine whether you should be eligible to receive payments. It’s important to have a workers’ compensation attorney on your side to help speed up the process.
Incomplete Documentation
Inaccurate or incomplete information can get in the way of your receiving your checks on time. It slows down claim processing of the initial complaint and results in repeated requests for more information, which you’ll then have to provide before the process can move forward. Avoid issues with incomplete documentation by having an experienced workers compensation lawyer look over your paperwork before you submit it.
Disputes and Appeals
Disputes between employees, employers, and insurance companies are at the heart of most delayed workers’ compensation checks. Conflict can arise over:
- The nature of the injury
- The extent of the disability
- The level of benefits
Initial disputes can escalate to formal denials and appeals, which further draw out the legal process of getting your claim approved. When this happens, it can take months or even years for you to get your check.
High Claim Volume
Major workplace incidents can leave workers’ comp insurers flooded with claims to process. There’s little that insurance companies can do about a sudden influx of claims. The increased workload almost inevitably leads to a delay in processing time.
System Inefficiencies
Some insurance companies run on outdated administrative systems that lack coordination, which creates unnecessary delays. If your employer’s workers’ comp insurer still uses manual data entry and paper-based documentation, you can expect the entire process to take longer than it should.
What You Can Do About Delayed Workers’ Comp Payments
If your workers’ comp payments have been delayed in the Golden State, the first thing you should do is to hire a workers’ compensation attorney. Your attorney will understand California workers’ compensation laws and how to use them to speed up the process. A lawyer can also uncover the source of any delays and explain to you what’s happening so that you know what to expect and what your next steps should be.
Whether you have a lawyer or not, you can follow up frequently on the status of your workers’ compensation claim. That way, you’ll know if there are delays caused by missing documentation on your part that could be more quickly resolved.
If your claim got denied, know that you are not alone. Around 7% of claims get denied the first time. There’s good news, too. Around 67% of those initial claim denials get converted into approvals within a year through the California Workers’ Compensation Appeals Board. It’s worth hiring a lawyer to help you resolve the issue. Lawyers only charge 9% to 15% of your benefit amount in contingency fees.
FAQs
Why Would My Workers’ Comp Check Be Late?
Your workers’ comp check could be late for several reasons. You could be having issues with a doctor failing to submit medical documentation, or the insurance company might just need more time to investigate the claim. If you’ve been receiving payments and they suddenly stop, mail delays, clerical errors, and changes in personal details can all be to blame.
What Shouldn’t I Say to a Workers’ Comp Claims Adjuster?
You shouldn’t say anything to a workers’ comp claims adjuster that could downplay your injury, admit fault, or reveal unnecessary personal information. Don’t speculate on the injury’s impact on your life, and don’t tell them that everything is “fine.” Answer their questions honestly, but don’t offer extra information. Stick to the factual details of the injury and accident.
What Is the 90-Day Rule for Workers’ Comp in California?
The 90-day rule for workers’ comp in California refers to the fact that if an employer or their insurance company neither accepts nor denies a claim within 90 days of your submitting the form, the claim is automatically approved, and the injury is assumed to be work-related. The rule requires insurers to authorize up to $10,000 in medical treatment even if the claim is still pending.
How Do I Track My Workers’ Comp Check?
You can track your workers’ comp check by contacting either your employer’s HR department or the insurance company directly. You’ll need to know your claim number so that you can ask about your payment’s status. You may also be able to track your check online using the insurance company’s portal, which may tell you when checks were mailed or direct deposits were made.
Hire a Workers’ Compensation Lawyer
If you’re struggling with any of these common reasons for delayed workers’ comp payments in California, we have the solution. Hire a workers’ compensation lawyer. You can reach out to Kampf, Schiavone & Associates for help. We’ve handled countless workers’ compensation cases, and we can get to the bottom of what’s causing your delayed payments, too. Contact us to schedule an initial consultation today.