What to Do if You Receive a Notice of Delay in a Workers Comp Case –
Occassionally applicants for Workers Comp will recieve a “Notice of Delay.” While this can be frustrating, if you have recieved a Notice of Delay, our attorneys can ensure that your employer MUST authorize all medical treatment for the injury, during the “delay” until the decision is reached.
If you have filed a Workers Compensation claim in the State of California, you already know that there are a lot of forms and paperwork involved. In fact there are over 100 different Official Forms used by the California Division of Workers Compensation in approving or denying workers comp claims!
More than ten of these official forms are Workers Compensation Notice forms. A Notice is typically sent to the injured worker to advise him or her of any change in the status of their claim, including: denial, delay or change in benefits.
The Most Common Workers Compensation Notices:
- Notice of Denial
- Notice of Change of Rate
- Notice of Delay in Determining Liability for Workers’ Compensation Benefits
- Notice of Denial of Claim for Workers’ Compensation Benefits
- Notice of Interruption or Deferral of Vocational Rehabilitation Services
- Notice of Medical Provider Network Plan Modification
- Notice of Offer of Modified or Alternate Work
The California Workers Compensation Laws governing these Notices set specific time periods in which the Notice(s) must be send – as well as limited time periods for contesting or appealing any of these notices. If you have received any notice, it is important to respond within the timeframe stated on the Notice if you disagree with its contents and/or you wish to take additional action.
What is a Notice of Delay in a Workers’ Comp Case?
One of the most commonly used forms in Workers Compensation cases is the Notice of Delay in Determining Liability for Workers’ Comp Benefits. This is a form used by the employer or the claims adjuster, when they want to conduct an investigation prior to accepting or denying the Workers Compensation Claim.
Our attorneys have found that employers often delay a claim because they want to interview witnesses, talk to co-employees, obtain the applicant’s medical records and/or have a medical evaluation conducted. If there is a “good faith” (genuine) need to investigate the claim prior to accepting it, the employer is allowed a maximum of 90 additional days to accept or reject the claim.
The Notice of Delay must be served upon the injured worker if the employer needs more time to accept or reject he claim. The 90 day period runs from the date that the employee files the workers compensation claim form. If the employer does not give a rejection within 90 days, it is “presumed” that the claim has been accepted, and that benefits must be paid.
Remember, workers comp is a “no fault” benefit – which means that IF the worker was injured or made ill at work as a result of work activities he or she is entitled to benefits. It does not matter who was “at fault” for the injury or illness. So when an employer delays a claim, they can typically only be questioning if the injury / illness / disability was work related, and/or if it prevents the employee from working.
Collecting Workers’ Comp Benefits Pending a Notice of Delay
The good news is that – if a Notice of Delay is served upon an injured worker – the employer MUST authorize all medical treatment for the injury, during the “delay” (period of investigation). And the employer must continue to provide the treatment up until the date the liability for the claim is accepted or rejected, up to a limit of $10,000.
Our Workers Comp Attorneys Can Help With Your Notice of Delay
Our experienced Long Beach Workers Compensation attorneys are here to help you with all aspects of your California Workers Comp Case – including a Notice of Delay that you have received. Our experienced lawyers would be happy to discuss your unique situation with you, to ensure that you receive the maximum workers compensation benefits for which you may qualify.