Get the denial letter and note the exact reason for denial
Check the claim filing deadline and any hearing deadlines
Gather all medical records, work notes, incident reports, witness statements, and photos
Request a copy of your complete workers’ compensation file
File an Application for Adjudication of Claim with the Workers’ Compensation Appeals Board if not already filed
File a Declaration of Readiness to Proceed if the case is ready for hearing
Request a Qualified Medical Evaluator if there is a medical dispute
If a panel QME is needed, request the panel promptly through the Division of Workers’ Compensation
Collect proof that the injury arose out of and occurred in the course of employment
Collect proof of when, where, and how the injury happened
Get a detailed report from your treating doctor addressing AOE/COE
Ask witnesses to provide written statements
Keep a log of symptoms, treatment, missed work, and communications
Respond to any requests for recorded statements or additional documents carefully
Do not miss any scheduled medical appointments or hearings
Keep copies of everything you send and receive
Consider filing for expedited hearing if benefits are being delayed
Consider requesting temporary disability, medical treatment, or other benefits while the dispute is pending
If the denial is based on preexisting condition, gather evidence of work-related aggravation or new injury
If the denial is based on late reporting, gather evidence of timely notice or employer knowledge
If the denial is based on credibility, gather consistent documentation and witness support
Contact a California workers’ compensation attorney if the denial is serious or benefits are being withheld
Follow all WCAB orders and deadlines exactly
Continue medical treatment and document all work restrictions
Save pay stubs, wage records, and mileage records
Communicate in writing whenever possible
Avoid signing settlement documents without review
Prepare for deposition, hearing, or mandatory settlement conference if scheduled