San Jose Workers’ Compensation Appeals Attorneys

Helping You Appeal Workers’ Comp Denials

Workers’ compensation is designed to help you stay financially stable as you recover from a work-related accident. However, workers’ comp benefits are not guaranteed. There are reasons why workers’ comp claims can be denied, and those reasons are used countless times each year to deny claims across the country.

If you were injured in a workplace accident in San Jose, then please know that Pacific Workers', The Lawyers for Injured Workers and our workers’ comp denial lawyers can help you explore your options. With more than 130 years of collective legal experience, we are prepared to navigate your case from start to finish. Through an appeal to the Workers’ Compensation Appeals Board (WCAB) and an administrative law judge (ALJ), we might be able to recover the benefits owed to you. If necessary, we can pursue a lawsuit if the claim was denied and fight for a settlement in your name.

Please call (888) 740-6434 to contact our San Jose workers’ compensation office now if your claim was denied for any reason.

When to Appeal a Workers’ Comp Claim Denial

Don’t assume that a workers’ compensation claim denial means that you can’t get workers’ comp benefits. No matter how straightforward or assertive the denial notification might have sounded, there could be a real chance to appeal the denial and get the benefits that you need. In many cases, denials happen due to a clerical error, like a simple filing mistake, so correcting the issue could be simpler than you think. It would be a shame to lose the benefits owed to you just because you don’t want to explore your legal options.

At our firm, we believe that anyone who has had their workers’ compensation claim denied can benefit from at least talking to our appellate attorneys. You will never know how much your life could be changed for the better if you take the denial letter at face value. With our legal counsel and representation, you will be ready to file the appeal, attend the appellate hearing, speak with an administrative law judge to prove your argument, and much more.

Why Workers’ Comp Claims are Denied

The start of the workers’ comp appellate process is to understand why your claim was denied. In the denial notification that you received, the reason should be explained clearly. If it is not, then it could constitute bad faith insurance, which is a different legal conflict altogether.

A few common grounds for workers’ compensation claim denials include:

  • No applicable workers’ compensation coverage
  • No medical treatment was necessary for the injury
  • No wages were lost due to the injury or recovery process
  • Injury was not reported in time
  • Claim was not filed in time
  • Claim was filed with errors
  • Credible accusations of intentional employee misconduct

Based on the reason for the workers’ comp claim denial, our team can start to build the argument to present during the appeal. If we think that an appeal is not the right course of action, we will let you know. Honesty and transparency are two of our foundational principles at Pacific Workers', The Lawyers for Injured Workers.

Basic Steps to File an Appeal

What does the workers’ compensation claim appellate process look like in California? You don’t need to worry about the details yourself, not when you have our San Jose workers’ comp appeals lawyers acting on your behalf. We are ready to help move your case forward in all circumstances.

Every appellate process is unique, but most will include these basic steps:

  • Filing an Adjudication of Claim with the local Department of Workers’ Compensation office.
  • Requesting a hearing before the WCAB.
  • Attending a mandatory settlement conference (MSC) to see if the issue can be solved through a settlement that doesn’t require a trial.
  • Preparing for trial if a settlement or the initial appellate hearing is not successful.
  • Attending the trial, presenting evidence and arguments, and awaiting the judge’s decision within 30 to 90 days.
  • Filing a petition for reconsideration if the judge’s decision was lawfully erroneous.

Call to Arrange a Free Consultation

Pacific Workers', The Lawyers for Injured Workers is here to help you make the most of your workers’ compensation appeal in San Jose. No matter what industry you work in or how you were injured at work, we can help you. Our experience and resources are extensive enough to handle any case with confidence, so put yours in trusted hands today.

For a FREE consultation, just dial (888) 740-6434.

We have Helped OVER 8,000 CLIENTS aND WE CAN HELP YOU TOO!

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Workers' Comp FAQ

  • Do independent contractors get workers’ compensation in California?

    No, most independent contractors are not covered by workers’ compensation insurance that is provided by their employer. The law does not require most employers to offer this sort of employment benefit to independent contractors. To get workers’ comp as an independent contractor, you will usually have to purchase a policy on your own.

  • What benefits can I seek with a workers' compensation claim in Oakland?
    In California, if you've been injured at work or diagnosed with a work-related illness, you can file a workers' compensation claim to seek benefits that cover a range of expenses. These benefits include medical costs, lost wages due to time off work, compensation for future earnings if you're unable to return to work, and expenses related to retraining or skill enhancement if you need to switch professions. Given Oakland's high cost of living, it's important to ensure your claim is accurately filed to receive all the benefits you're entitled to.
  • My Employer Said That I’m an Independent Contractor, Not a Regular Employee, so I Can’t Get Benefits. Is This True?

    You’re not necessarily an independent contractor by law if the nature of your job doesn’t fit the description, an attorney may help analyze your situation and guide you in this matter. There are high chances of contractors being eligible for workers’ compensation benefits, so it’s always worth trying.

  • Am I Eligible for Workers’ Compensation?

    In California, all employees are eligible for workers’ compensation with very few exceptions. If you are classified as an “employee” (rather than an “independent contractor”), you are eligible to receive benefits. This is true regardless of how many employees your employer has, how many hours you work, how much you make, whether you work part-time or full-time, or whether you are a seasonal worker. Additionally, undocumented workers are also eligible for workers’ compensation granted they meet all other eligibility requirements. In contrast, independent contractors and certain other workers, including some volunteers, household workers who are employed by a family member, and others, are not able to file for workers’ compensation benefits.

  • What is the California 90-day rule for workers’ compensation?

    After you inform your employer about your workplace accident, they need to tell the insurance company as soon as possible, usually within the same workday. Then, the claim administrator has 90 days to accept or deny your claim, with medical benefits being provided throughout that time. If there is no response within 90 days, then your claim ends in your favor by default.

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