If your workers’ compensation claim has been denied, you’re probably feeling frustrated, overwhelmed, and maybe even a little defeated. You did everything right—you reported your injury, followed your employer’s process, and sought medical care—yet the benefits you were counting on to pay bills and recover have been taken off the table.
Unfortunately, workers’ comp denials are more common than most people realize, and many are based on technicalities rather than the actual facts of your injury. You might have missed a filing deadline, failed to use an approved doctor, or received a medical report that didn’t fully capture your condition. In other cases, employers or insurance companies may challenge your claim by arguing that your injury didn’t happen at work or is related to a pre-existing condition.
But here’s the good news: A denial is not the end of your case. Under California law, injured workers have the right to challenge and appeal a denied claim, and many of those appeals result in favorable outcomes when supported by proper evidence and legal representation.
One of the most common reasons for denial is simply missing the deadline. In California, you must report your work injury to your employer within 30 days of the incident. Waiting too long—even if you were trying to tough it out—can give the insurance company a reason to deny your claim.
Your employer or their insurer may argue that your injury did not happen at work, or that it occurred off-duty or outside the scope of your employment. This is especially common with repetitive stress injuries, slips and falls near entrances, or injuries that happen while commuting.
In some cases, your employer may suggest that the injury was due to personal activities, pre-existing conditions, or a non-work-related accident. Even if the injury occurred on the job site, they may try to shift the blame to avoid liability.
Insurers often deny claims by pointing to pre-existing conditions, arguing that your current injury is just an aggravation of an older one and therefore not eligible for workers’ comp benefits. However, California law allows benefits for aggravations of pre-existing injuries—you just need the right medical evidence.
If your medical records are incomplete, vague, or inconsistent, the insurance company may argue that your injury isn’t serious enough to warrant benefits. Likewise, failure to follow through with treatment or not submitting proper documentation can lead to a denial.
Though rare, insurers sometimes allege that a claim is exaggerated or fabricated. If your claim raises any red flags—such as no witnesses, delayed reporting, or conflicting statements—you may be accused of fraud, even if your injury is completely legitimate.
In some cases, especially early in a claim, workers are required to see a doctor from the employer’s Medical Provider Network (MPN). If you go outside that network without following proper procedures, your claim could be denied for unauthorized treatment.
Start by reading the denial letter from the insurance company. It should include a reason for the denial, whether it’s due to missed deadlines, lack of medical evidence, or a dispute about how the injury occurred. Understanding why your claim was denied is the first step toward building a stronger case on appeal.
Now is the time to get organized. Collect all documents related to your injury and claim, including:
Having a complete record helps your attorney identify missing elements and prepare a solid response to the denial.
It’s easy to feel discouraged, but don’t assume the denial is final. In California, you have the right to appeal, but you must act quickly. The first step is filing an Application for Adjudication of Claim with the Workers’ Compensation Appeals Board (WCAB)—typically within one year from the date of injury or denial.
Delays or missed deadlines can cost you your entire claim.
Appealing a denied claim involves strict procedures, legal filings, and often a hearing before a workers’ comp judge. An experienced attorney can review your case, gather the necessary medical evidence, and represent you through every stage of the appeal.
At Tim D. Wright Law, we’ve helped many injured workers in Burbank and across Los Angeles County turn denials into successful outcomes. We know the system, we know your rights—and we’re ready to fight for you.
The first step is to file an Application for Adjudication of Claim with the Workers’ Compensation Appeals Board (WCAB). This form notifies the state that you are formally disputing the denial and asking for your case to be assigned to a judge.
Deadline: This application must generally be filed within one year of your injury or the date your benefits were last provided or denied.
Once your case is on file, the WCAB will schedule a Mandatory Settlement Conference (MSC). This is a meeting between you, your attorney, and the insurance company (or their lawyer) to try to resolve the dispute without going to trial.
During the MSC:
If the claim isn’t settled at the MSC, your case will be scheduled for a formal hearing in front of a workers’ compensation judge. This is your opportunity to:
After the hearing, the judge will issue a written decision. This can take several weeks, but it’s legally binding—unless appealed.
If the judge rules against you, you have the right to file a Petition for Reconsideration within 20 days of receiving the decision. This asks the WCAB to review the judge’s findings and consider whether errors were made.
Additional appeals can also be made to the California Court of Appeal, but this is a more complex and limited process.
The appeals process involves deadlines, legal documents, and courtroom-style hearings. It’s easy to make procedural mistakes that could cost you your case. That’s why having an experienced workers’ compensation attorney—like Tim D. Wright—is so important.
At Tim D. Wright Law, we help injured workers in Burbank navigate every step of the appeals process. We gather medical evidence, prepare strong legal arguments, represent you in hearings, and fight to get your benefits reinstated or approved.
A denied workers’ comp claim can feel like the end of the road—but it’s not. In many cases, a denial is simply the beginning of your legal right to push back, correct the record, and demand the benefits you’re owed. Whether it’s a paperwork error, a disputed injury, or an unfair insurance decision, the workers’ compensation system allows you to appeal—and with the right legal help, your case can still succeed.
At Tim D. Wright Law, we understand how stressful it is to suffer an injury and then be denied the support you need to recover. That’s why we’ve dedicated our practice to standing up for injured workers in Burbank, Van Nuys, and throughout Southern California. We’ll help you understand your denial, fight it effectively, and maximize every available benefit—from medical care to wage replacement and beyond.
We offer free consultations, and you pay no legal fees unless we win your case. If your claim has been denied, don’t wait—strict deadlines apply, and the sooner we get started, the stronger your position.
Workers’ Comp Office:
📍 7657 Winnetka Ave. #134 Winnetka, CA 91306
📞 Phone: (323) 379-9995
✉️ Email: firm@timwrightlaw.com
🌐 Website: https://www.timwrightlaw.com
