California Workers’ Comp Claims Denied?

Discover the Requirements for Qualifying for Workers' Comp Benefits

Workers’ compensation benefits are a crucial lifeline for employees who sustain work-related injuries or illnesses. These benefits provide financial assistance, medical treatment, and rehabilitation support to help employees recover and return to work. When workers comp claims are denied, a closer look must be taken regarding whether the qualifying requirements have been met. 

The first requirement is that the injury or illness must have occurred while the employee was performing job-related duties. This means that the injury must have taken place during working hours or while the employee was carrying out job responsibilities. 

The injured employee must be classified as an employee, not an independent contractor or volunteer. 

Employers may attempt to evade their responsibilities by not carrying workers’ comp insurance or misclassifying employees as independent contractors. It is important for workers to verify their employer’s insurance coverage to ensure they are eligible for benefits in the event of an injury.

The first step is to promptly notify the employer about the injury or illness. Failure to report an injury within a certain timeframe can result in the denial of the claim. It is important to provide precise details about the incident, including the date, time, location, and circumstances surrounding the injury.

After notifying the employer, injured workers should consult with a medical professional for evaluation and treatment. The medical evidence and reports from these evaluations play a vital role in substantiating the claim. 

Discover the Requirements for Qualifying for Workers' Comp Benefits​

California law requires that employers, including those in the construction industry, carry workers’ compensation insurance, even if they have only one employee. Insurance exists for employees who get hurt or sick because of work. [1] 

Determine the Reason for Denial of Workers' Compensation Claims

Addressing the Objections

When workers’ comp claims are denied, it’s important to remember that there are steps you can take to remedy the objections and fight for the benefits.

If your employer disputes your workers’ compensation claim, gather evidence to support your case. This can include employment records, witness statements, surveillance footage, or any other documentation that proves your injuries occurred at work.

An experienced workers’ compensation attorney can guide you in collecting the necessary evidence and presenting a strong argument to counter your employer’s objections.

The process of overturning a denied workers’ compensation claim can be complex, so seeking assistance from an experienced attorney specializing in workers’ comp can increase your chances of success. 

Addressing the Objections​

Submit an Appeal

Consider Hiring an Attorney

If you’ve had your workers’ compensation claim denied, you may be feeling frustrated and unsure about what to do next. One of the best steps you can take is to hire an experienced workers’ compensation attorney to assist you in the appeals process.

Consider Hiring an Attorney

Hiring an attorney is not a guarantee of success, but it significantly increases your chances of a favorable outcome.

If you’re facing a denied workers’ compensation claim, don’t hesitate to consult with a workers’ comp attorney from Goldberg & Loren. They will assist you through every step of the appeals process. 


[1] California, S. O. (n.d.). Workers’ Compensation Requirements. Workers’ Compensation Requirements.

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