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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.


    Thank you for being so kind and completely sympathetic to my case!

    “I started my fight against my company's workers comp and after talking to Almarie for the first time I already felt a lot of weight off my shoulders. It feels nice to have someone fighting for your rights but also keeping you in check for your own good.”

    Jazzie D. Daly City, CA
    They took care of me!

    “Bilal worked on my case and he was very professional, friendly, and kind to me. I was so nervous about my deposition and he made me feel very comfortable and less stressed about the whole situation.”

    Gabi O. Sacramento, CA
    The most down to earth team I have ever met!

    “They have strong communication and I was respected throughout the whole process. They had never given up on me!”

    Nekealla C. Tracy, CA
    I'm forever grateful & thankful to all!

    “I especially want to thank Mr. Jason Insdorf, who worked in attaining a settlement I never expected.”

    L.S. Union City, CA

Workers' Comp FAQ

  • 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.

  • Can't I Just File for Workers' Compensation on My Own?

    Filing for workers' compensation on your own increases the chances that your claim will be denied. One small misstep can prevent you from obtaining the compensation you need for your injuries. In addition, the process is usually complex and tedious, especially for someone with no workers' compensation law experience. It is extremely advantageous that you seek reliable and experienced legal guidance for your claim.

  • What Can I Expect from the Workers' Compensation Process?

    As soon as you reach out to us for help, we will assign you a full-time case manager and attorney. An application will be filed with the Workers' Compensation Appeals Board (WCAB) on your behalf. We will get started on your case immediately to help you receive the medical care you need. If we are unable to receive a fair settlement from the insurance company, we are ready and willing to take your case to trial. After a few months, you will most likely give a deposition. One of our highly experienced attorneys will prepare you and stand at your side the entire time. You don't even have to attend court hearings! One of our trained hearing officers or attorneys can attend on your behalf.

  • Can My Employer Tell Me to Use Sick Time or Vacation/Personal Time off (PTO) If I’m Injured at Work?

    Following a work-related injury, you may not receive workers’ compensation benefits right away or your workers’ compensation claim may be denied. You may receive a note from your doctor that you may take time off work due to your injuries, but how will you be paid if you are not actively seeking workers’ compensation benefits? Your employer may tell you to use your state-mandated/employer-provided sick time in order to continue being paid while you are out of work. Once this sick time is exhausted, your employer may tell you that the only way you can continue to be paid is if you use your vacation or PTO time. In some cases, this may actually be the only way to continue receiving wages while you are out of work and not receiving workers’ compensation benefits. For more information, check out our video with Attorney Bilal Kassem on this topic by visiting our Facebook page!

  • Can I Get Workers’ Compensation If I Was Fired?

    If you were terminated while already receiving workers’ compensation benefits, this does not necessarily affect your right to receive benefits. However, if you were terminated “for cause” (for example, if you were fired because you were caught stealing from your employer), you will not be able to continue collecting benefits. If you were not fired for cause, but were laid off due to your position being terminated or various other reasons, you may still be able to continue collecting your workers’ compensation benefits. If you believe you were terminated because you filed for workers’ compensation or because you were hurt at work, you may have grounds for a retaliation claim. Learn more, including whether you can continue receiving workers’ compensation benefits if you were laid off due to the coronavirus pandemic, see our video with Attorney Bilal Kassem on our Facebook page.

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