Denied Workers’ Comp Claim in Woodland Hills

Fight Back Against a Denial With Attorneys Who Know How Insurers Think

A denial letter isn’t the end of your claim. In California, it’s the beginning of a formal process that can still put benefits in your hands. What matters most right now is acting before deadlines close off your options. Our team at Rodich Law has represented thousands of workers throughout Los Angeles and recovered over $500 million for injured clients. We offer a free consultation to review your denial, and we don’t charge a fee unless we win.

What sets our approach apart is perspective. Gary Rodich spent years working for insurance companies before switching sides to represent injured workers. He has also served as a Pro Tem Judge, giving him direct knowledge of how decisions are weighed once a case reaches a hearing. That dual background shapes how we read a denial letter and how we build the challenge to it.

If you’ve received a denial on your workers’ compensation claim, call us at (818) 403-3737 for a free, no-pressure review. Appeal deadlines apply, and we’re ready to help you understand your next step.

Why California Workers’ Comp Claims Get Denied

Many valid claims are denied not because the injury didn’t happen, but on procedural or evidentiary grounds that can be challenged. Understanding why your claim was denied determines whether and how it can be challenged. We review every denial letter to identify the insurer’s stated grounds and advise on the path forward.

Common denial reasons we see in Woodland Hills workers’ compensation cases:

• Late injury reporting: Delays in notifying your employer give insurers an opening to argue the injury didn’t occur at work. A delayed report doesn’t automatically forfeit your rights, but prompt reporting matters.
• Insufficient medical documentation: The insurer may contend your medical records don’t establish that the injury is work-related or as serious as claimed.
• Gaps in treatment: Discontinuing care can be used to argue your injury doesn’t warrant ongoing benefits. Continuing treatment protects your claim.
• Disputed work-relatedness: The insurer may claim the injury happened off the clock, during horseplay, or while under the influence of alcohol or drugs.
• Independent contractor misclassification: Some insurers deny claims by arguing the worker wasn’t an employee at all. This argument is frequently challengeable.

One important protection: under California Labor Code §5402, if the insurer doesn’t accept or reject a claim within 90 days of receiving the DWC-1 form, the injury is presumed compensable. Separately, while your claim is under investigation, the insurer must authorize up to $10,000 in medical treatment. We identify when these protections apply to your situation.

What to Do Immediately After Receiving a Denial

Read the denial letter carefully. The stated reason tells us which grounds the insurer is relying on and where to focus the challenge. Keep every document connected to your denied claim: the denial letter, your DWC-1 form, medical records, wage records, and any written communications with your employer.

Don’t stop medical treatment. Gaps in care are a standard insurer argument that your injury is less serious than claimed, and continuing treatment creates the documentation your appeal depends on. Under California Labor Code §5405, the Application for Adjudication of Claim must generally be filed within one year of the date of injury or the last date benefits were provided. Workers in Woodland Hills file through the DWC Van Nuys District Office, which handles Los Angeles County cases in the San Fernando Valley.

From the first call, we can review the denial letter, identify the grounds, and handle all paperwork, medical record gathering, and communications with the insurer and the DWC on your behalf. You don’t navigate this alone.

How We Build a Denied Claim Into a Winning Appeal

We’ve been through the appeals process thousands of times. Our approach starts with a precise read of the denial grounds, then builds the evidentiary record to challenge them.

Independent Medical Evidence

When a claim is disputed on medical grounds, we can seek evaluation from an independent medical specialist. A qualified medical evaluator (QME) or agreed medical evaluator (AME) produces a medical-legal report that carries significant weight and can outweigh the insurer’s doctor’s opinion. The right specialist matters as much as the process itself.

Results From Overturned Denials

Two cases illustrate what overturning a denial can mean:

• A repetitive work injury case was denied by the insurance company and employer. After we overturned the denial, we secured multiple back surgeries for the worker and obtained a $1,200,000 award with lifetime benefits.
• In a silicosis case, the defendants denied work-relatedness and refused to authorize a needed lung transplant. We retained a top pulmonologist specializing in lung injury and secured a $2,000,000 settlement.

If a workers’ compensation judge issues an adverse decision, a Petition for Reconsideration with the Workers’ Compensation Appeals Board (WCAB) must be filed within 20 days of service of the decision, or 25 days if served by mail, under California Labor Code §5903. We track these deadlines and handle the filings.

Board Certified Representation for Woodland Hills Workers

Gary Rodich holds a Board Certified Specialist designation in workers’ compensation from the California State Bar, a certification that requires demonstrated expertise beyond standard licensure. Barry Rodich was named to the Super Lawyers Rising Stars list in 2023, a recognition given to no more than 2.5% of attorneys in California. Together, they bring 50 years of combined experience to every denied claim we take on.

Gary’s background working for California workers’ compensation insurance carriers means he understands how insurers construct denial arguments from the inside. His time as a Pro Tem Judge adds direct knowledge of how those arguments are weighed at the hearing stage. Barry maintains personal accessibility throughout each case, keeping clients informed and ensuring there’s always a point of contact. We serve workers throughout Woodland Hills and the greater Los Angeles area.

Free Consultation for a Denied Workers’ Comp Claim in Woodland Hills

A denial doesn’t have to be the final word. Appeal deadlines are real, and acting promptly keeps your full range of options open. Call Rodich Law at (818) 403-3737 or reach us through our online contact form to schedule your free consultation. There’s no charge for the review and no attorney fee unless we win your case.