Workers' comp claim denied in California: what to do next

Call or visit an Information and Assistance officer (free) to understand the denial and your options. Then, to have a judge decide, file an Application for Adjudication of Claim at the DWC district office in the county where you live or were injured, and serve it on the claims administrator.

Your employer's insurer, not the state, usually decides first. If they deny or delay, the free help listed here can explain your options.

Checked against official sources: October 31, 2026.

Deadlines are strict. If you are near one, call the state agency or free help today.

If your claim is denied or delayed in California

Who decides: Workers' Compensation Appeals Board (WCAB), with judges at 23 DWC district offices plus satellites
First step: Call or visit an Information and Assistance officer (free) to understand the denial and your options. Then, to have a judge decide, file an Application for Adjudication of Claim at the DWC district office in the county where you live or were injured, and serve it on the claims administrator.
Form: Application for Adjudication of Claim
Deadline: Proceedings must be started within 1 year from the date of injury, the last temporary disability payment, or the last medical treatment provided, whichever is latest.
Medical disagreements: If you disagree with your treating doctor's report on issues other than a specific treatment, and you have no attorney, object in writing to the claims administrator within 30 days of receiving the report and request a panel of qualified medical evaluators (QME) on Form 105. If treatment your doctor asked for is denied or changed by utilization review, request Independent Medical Review (IMR) within 30 days after the decision is served on you (10 days for drug formulary disputes).
: Request for QME panel (Form 105)
Independent Medical Review (IMR) information and request form
Appealing the decision: Petition for Reconsideration to the Workers' Compensation Appeals Board.

File an Application for Adjudication of Claim at a DWC district office and serve it on the other parties. You get a case number that starts with 'ADJ'.
File a Declaration of Readiness to Proceed to ask for a hearing. The first hearing is a mandatory settlement conference with a judge.
If the case does not settle, a trial is set before a judge. The judge mails a written decision, usually 30 to 90 days after the trial.
If you disagree with the decision, you can file a Petition for Reconsideration.

Law: Cal. Lab. Code §§ 4062(a), 4610.5(h), 5405

Source: dir.ca.gov

Sources

The official sources for California are listed on the California page.

National rules that may also matter

Not covered by state workers' comp?

These federal programs and laws cover some groups of workers instead of, or in addition to, state workers' compensation. If one of them may apply to you, check its rules and deadlines too. They are different from your state's.

Federal Employees' Compensation Act (FECA): Civilian employees of the federal government, including Postal Service employees. Official page

Longshore and Harbor Workers' Compensation Act (Longshore Act): Maritime workers such as longshore workers, harbor workers, ship repairers, shipbuilders and ship-breakers, hurt on navigable waters of the United States or on an adjoining pier, wharf, dry dock, terminal or other area used to load, unload, repair or build ships. Some groups are excluded. Official page
Longshore maximum and minimum for October 1, 2026 to September 30, 2027 (fiscal year 2027): maximum $2,163.92 a week, minimum $540.98 a week.

Law: 33 U.S.C. 906(b); DOL Longshore NAWW table

Defense Base Act: Civilian employees working outside the United States on U.S. military bases or under a contract with the U.S. government for public works or national defense. Claims are handled by the Longshore program. Official page

Federal Black Lung Program: Coal miners who are totally disabled by black lung disease (pneumoconiosis) from coal mine work, and survivors of miners whose deaths were caused by it. Official page

Energy Employees Occupational Illness Compensation Program: Current or former employees of the U.S. Department of Energy and its contractors and subcontractors, and certain uranium miners, millers and ore transporters, who became ill from toxic exposures such as radiation, beryllium or silica at covered work sites, and their survivors. The program is set up by the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). Official page

Railroad workers (Federal Employers' Liability Act): Employees of railroads in interstate commerce. Instead of a workers' compensation claim, a federal law lets an injured railroad worker sue the railroad for damages caused by its negligence.

Seamen (Jones Act): A seaman injured in the course of employment may bring a lawsuit against the employer, with the right to a jury trial, under the same federal rules that apply to railroad workers.

National help

Your state workers' compensation agency answers questions about claims. Many have a free help line, an ombudsman or information officers for injured workers.

The Legal Services Corporation funds 129 nonprofit legal aid organizations in every state, D.C. and the territories. Enter your address on its website to find one near you. You can also look up legal information and free forms at LawHelp.org. Whether a local program handles workers' compensation cases varies.

LawHelp.org