Many workers in California qualify for workers’ compensation benefits following a workplace accident. However, not every claim for workers’ compensation benefits is approved. Your employer’s insurance company will carefully evaluate your claim and review the evidence before making the decision to approve your claim. If your claim is denied in California, it may be for one of the following reasons:
- Your employer claims that your accident and injury/illness did not occur at work or was not work-related.
- You were intoxicated or were roughhousing at the time of the accident.
- You did not notify your employer of your work-related injury/illness within 30 days of the injury/illness or discovery of the injury/illness.
- You did not seek treatment for your injury/illness.
- You did not file your workers’ compensation claim on time.
What should you do if your claim was denied?
In California, you have the option of appealing a judge’s decision to deny your workers’ compensation by filing a petition for reconsideration with the California Workers’ Compensation Appeals Board (WCAB).
The petition must be filed within 20 days of receiving the notice of denial, or within 25 days if the notice of denial was mailed. You may provide evidence to support your reasons for appeal, including medical records, expert testimony, witness testimony, and any new information that has come up since the original claim was made. It is important that you review your denial letter carefully so that you address those specific reasons in your appeal.
Following a hearing in front of a judge, the WCAB will decide whether to uphold your denial or overturn it. If your appeal is denied, you may then file a writ of review with the state court of appeals.