Appeals

Woodland Hills Attorney for Workers' Compensation Appeals

Appealing Denied Workers' Comp Claims in California

If you have received a notice that your workers' compensation claim has been denied, you are not alone. Thousands of claims are wrongfully denied every year, even for valid injuries. A majority of these denials are often due to technicalities in paperwork or insufficient evidence proving the work-related injury.

It is important that you speak with an attorney about possibly appealing your claim. Whether your denial was for a technicality or insufficient evidence, do not give up.

Our Woodland Hills workers' compensation legal team at Rodich Law can fight for you. We have been through the appeals process thousands of times and have an in-depth understanding of what it takes to obtain the benefits you deserve.

Common Reasons Workers' Comp Claims Are Denied

Injured workers may be denied workers compensation for a variety of reasons. However, the most common reasons for a work injury claim denial include:

You waited too long to file - The law requires that you report claims immediately. Otherwise, it can be easier for your employer to dispute that the injury even happened at work.
Not enough medical evidence - You must provide medical records demonstrating the severity of your injury.
Did not receive medical treatment - Once you see a doctor, you must continue receiving treatment to show the necessity of benefits.

Our workers comp attorneys can overturn a denial for any of these reasons and more.

Appealing a Workers' Comp Denial in California

Appealing the decision of workers' compensation insurance can be complex, and error at any point can jeopardize your case.

The process of appealing a worker's compensation case includes:

Fill out an Application for Adjudication of Claim form and submit it to your local DWC office.
The DWC office will confirm it has received your application and assign a case number. This number should be used on all documents related to your claim.
File a Declaration of Readiness to Proceed. This form requests a hearing with a Judge. During the hearing, the judge will look over your case and attempt to reach a settlement with the claims administrator.
If a settlement is not successful, a Trial can be scheduled before another judge, who will make a decision.
If you would like to appeal the Judge's decision to the Workers' Compensation Appeals Board, you can file a Petition for Reconsideration within 20 days.
These steps are extremely complicated and unless you have intimate knowledge of the system should not be attempted on your own.

In the state of California, you are able to request a hearing in front of a Workers' Compensation Appeals Board (WCAB) judge by filing a Declaration of Readiness to Proceed form. This informal trial gives you an opportunity to plead your case in a court of appeal, before a judge.

The workers compensation judge will hear both sides of the case - yours and the insurance company's. The judge will then decide whether the claim should be accepted or not.

Unless you have intimate knowledge of the system, this process should not be attempted on your own. Our legal team can help you build a strong case using medical evidence. We can seek the evaluation of an independent medical specialist who can provide non-biased evidence.

Schedule a Free Consultation

Start by contacting an attorney at our law firm and discussing your denied claim. We can review your situation and advise you on how to proceed with your appeals. With decades of experience behind us, we can provide effective guidance through every step of the process.

If we do not win you workers compensation benefits, you do not pay us legal fees. Take action immediately, as claims are time-sensitive. Contact us at (818) 403-3737.

$11,000,000 Catastrophic Auto vs Motorcycle Accident
One of our clients was catastrophically injured in an auto vs motorcycles accident. as a result of the accident the applicant lost use of his left arm below his shoulder. Multiple medical procedures later and with additional issues to the workers neck and back and the need for life time medical treatment and care. Our client received an 11 million dollar settlement assuring that he will never have to work another day in his life and that all his medical needs will be taken care of.
$11,000,000 Injured Worker
Settlement for an injured worker who lost the use of his arm in an auto accident going home from work. Our client was leaving work to make a delivery for his employer. He, unfortunately, entered into a serious auto accident which resulted in the total loss of use of his arm along with neck, back, and psychiatric injuries. Future medical was going to result in multiple surgeries and possible psych hospitalization. Two years of negotiation netted out client a settlement of $11,000,000.
$4,876,000 Payments & Treatment for Life
Our client sustained an injury when he was run over by a car. After receiving considerable medical treatment for several years, our client received a civil settlement of $4.75 million. Traditionally when an injured worker receives a civil settlement, the settlement proceeds are deducted against any award they receive in Workers Compensation. At trial, our office was successful in getting Defendant to waive any credit rights they had. Additionally, we were able to get our client an additional $126,000...
$3,200,000 Pedestrian Accident Victim
Our client was crushed between a tow truck and a pole. as a result of the injury the applicant was hospitalized for 30 days and developed back, neck, and leg problems. the injured worker also developed a blood problem that required lifetime medicine to manage medical issues which arose from thyroid issues that were aggravated by the worker's injury. The insurance company and our firm were able to resolve the continuing costs of the treatment and medicine for over 3 million dollars...
$2,600,000 Brain Injury Settlement
This case involved an Applicant falling and sustaining a brain injury. After two years of benefits, getting the spouse paid for taking care of her husband, surgeries, and treatment at the Center for Neuro Skills, we were able to get this case to 100% and a settlement of 2.6 million.
$2,000,000 Lung Transplant for Silicosis Client
This case has to do with a need for a lung transplant with one of the Silicosis clients we represent. Defendants denied this matter as being work-related. They refused to accept the need for benefits, treatment, and care. We obtained medical reporting from one of the top pulmonologists whose practice emphasizes lung injury and the need for lung transplants.
$1,300,000 Back Injury
A machine operator represented by Rodich Law injured her back while lifting a box of thread at work. After a long and difficult course of treatment and care, it was ultimately decided she needed surgery. The insurance company refused to authorize the back surgery. Rodich Law forced the insurance company to trial on the issue of back surgery. After convincing a Judge to authorize the back surgery the applicant underwent the surgery the applicant’s case eventually settled for $1.5 Million dollars.
$1,255,000 Wage and Hour Suit & Injured Back
The injured worker sustained injury on the job to his low back. Initially Defendant offered $5,000 dollars to resolve the case. The offer was rejected and ultimately Rodich Law won at Trial on the issue of injury. Rodich Law then obtained benefits for the injured worker. In review of the wage statements provided by Defendant, Rodich Law noticed wage and hour violations. Our office was able to assist in procuring a $1.2 million settlement on behalf of the injured worker...
$1,200,000 Lifetime Benefits - Repetitive Work Injuries
The applicant sustained an injury to his neck and back due to repetitive work. The case was originally denied by the insurance company and employer. After successfully overturning the denial, we were able to obtain multiple back surgeries for the applicant. Defendant made an offer of $150,000.00 which was rejected. After taking the case to trial, we were able to obtain an award of 100% which guaranteed the applicant lifetime benefits...

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“I'm so glad I used Rodich Law to get my case going against Wal-Mart. It was a long case, and wasn't easy for me to make all the appointments and doctor visits, but eventually we won a great settlement for me.”

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“From the very first meeting with Gary and Lucy, I knew that all the reviews I read were true. They truly know the ins and outs of workers compensation and Lucy and the team were accessible, professional and were always there to help in anyway they could.”

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