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Tracy Workers’ Compensation Appeals Attorney

Appealing a Denied Workers’ Compensation Claim

Every year, millions of Americans are injured at work—but many of these individuals are denied workers’ compensation benefits. If you have filed for workers’ compensation and your claim has been denied, you have the right to appeal.

We strongly recommend that you work with an experienced workers’ compensation attorney if you wish to appeal a denied workers’ comp claim. The process of appealing is a complicated one; an attorney can help ensure that you do not make any mistakes that could jeopardize your claim.

At Pacific Workers', The Lawyers for Injured Workers, we have more than 130 years of combined legal experience. What’s more, we devote a significant portion of our practice exclusively to California workers’ compensation law. This dedicated focus has granted us the in-depth knowledge, skill, and resources necessary to effectively handle all types of workers’ compensation-related matters, including appeals. Our team is widely recognized as an authority in the area of workers’ compensation law, with more than $125 million recovered on behalf of our clients.

Contact our Tracy office today at (888) 740-6434 to speak to one of our workers’ compensation appeals attorneys about your denied claim.


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

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    L.S. Union City, CA

Why Appeal a Denied Workers’ Compensation Claim?

Although it may seem easier to start over—or hopeless to fight back—when your workers’ compensation claim is denied, there are numerous reasons to appeal. According to data from Lockton, the world’s largest independent insurance brokerage, almost 70% of denied workers’ compensation claims are ultimately paid within the year. Even more surprising, the same data found that converted claims (those initially denied and ultimately paid) awarded approximately 55% higher payouts than the initial amount claimed.

Appealing a denied workers’ compensation claim isn’t just your right; it is also an opportunity to recover the benefits you rightfully deserve, and the overall likelihood of success is relatively high. However, there are no guarantees, and your chance of a successful appeal depends on numerous factors. One of these factors is the legal representation you choose.

Having the right attorneys by your side during the appeals process can make a significant difference in the outcome of your claim. You want a team that has extensive experience handling workers’ compensation claims and appeals, a team that has the resources and know-how to effectively build your case and protect your rights. At Pacific Workers', The Lawyers for Injured Workers, we have successfully helped countless clients navigate the workers’ compensation appeals process, from the initial filing stage to appearing at mandatory hearings and other related proceedings. When you choose our firm to assist you with your denied claim appeal, you can trust that we will do everything possible to recover the benefits you are owed. Our Tracy workers’ compensation appeals attorneys will be there for you every step of the way.

Common Reasons Workers’ Compensation Claims Are Denied

It is important to understand why your claim may have been denied, as this can impact your ability to appeal, as well as the appeals process.

Some of the most common reasons that workers’ compensation claims are denied include:

  • Disputes over coverage/eligibility
  • Accusations of employee negligence or misconduct
  • Lack of medical treatment
  • Lack of time off due to an injury or illness
  • Failure to report the injury
  • Failure to meet applicable deadlines
  • Mistakes or lack of adequate information on the initial claim
  • Administrative errors

Our attorneys can sit down with you to discuss your case and review your initial claim to determine why it was denied. We can then advise you as to the best course of action, including whether we believe you have grounds to appeal. There is no cost and no risk in talking to a member of our team today about your legal rights and options.


How to Appeal a Denied Workers’ Comp Claim in California

There are several steps involved in appealing a denied workers’ compensation claim in California. Here, we have provided a brief overview of the workers’ comp appeals process, but keep in mind that the exact steps you may need to take could differ depending on your unique situation. We recommend that you use this overview as a guide of what to expect and, for more detailed information regarding your circumstances, reach out to our Tracy workers’ compensation appeals lawyers for a free consultation.

The steps involved in appealing a denied workers’ compensation claim in California include:

  • File an Adjudication of Claim: This application is a part of your official workers’ compensation claim and provides your case with a number. You must file your Application for the Adjudication of Claim at the Department of Workers’ Compensation (DWC) office in the county where you live or were injured (if different).
  • Request a Hearing: Once your Application for Adjudication of Claim has been received, and you have been given a case number, you can request a hearing before a Workers’ Compensation Appeals Board (WCAB) judge by filing a Declaration of Readiness to Proceed. Once you have filed this form, you may be schedule for a mandatory settlement conference (MSC).
  • Attend the Pre-Trial Conference: The MSC serves as a pre-trial hearing with the intended purpose or resolving the issue without having to proceed to trial. At the conference, you, your case administrator, and both your legal representatives will provide evidence in support of your respective claims to the judge. The judge will attempt to resolve the dispute through settlement.
  • Prepare for Trial: If your workers’ compensation dispute cannot be resolved at the pre-trial hearing, you and your legal representation will need to prepare for trial. This typically involves putting together various documents, gathering evidence, and assisting witnesses in preparing to provide testimony.
  • Attend the Trial: Your presence is required at the trial, which will be held before a different judge than the one who presided over the pre-trial conference. Once both parties have presented their sides, the judge will decide on the case and provide a written decision by mail within 30 to 90 days.
  • File a Petition for Reconsideration: If you disagree with the judge’s decision, you may request a reconsideration. To do so, you will need to file a petition within 20 – 25 days of receiving the judge’s written decision. You are only allowed to request a reconsideration in certain circumstances; an attorney can help you determine if you have grounds to take this step.

Appealing a denied workers’ compensation claim in California is a complex and time-consuming process. It is extremely important that you work with a skilled legal team that knows how the system works and can protect your rights every step of the way.

Schedule a Complimentary Consultation

At Pacific Workers’ Compensation Law Center, our Tracy workers’ compensation appeals attorneys are here to fight for you and your rights. We are dedicated almost exclusively to the practice of workers’ compensation law, allowing us to devote all of our time, efforts, and resources to helping injured employees recover the fair benefits they are owed. We are well-versed in the appeals process and know how to protect your best interests every step of the way.

With over 250 four- and five-star reviews from our clients, we are the people’s choice for workers’ compensation representation in Northern California. Learn how our award-winning firm can assist you with your claim today.

Contact us online or call us at (888) 740-6434 to get started with a no-cost, no-obligation consultation.

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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