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✦ Board-Certified Specialist in Workers’ Compensation Law — State Bar of California ✦
A denial is not the end. It’s the beginning of our fight for your benefits.
By Eman Yazdchi, Esq. · Certified Specialist in Workers' Compensation Law
A denied workers' comp claim is not the end of your case. It is a decision made by an insurance company that has a financial incentive to deny every claim it can. For Newhall workers, those denials hit hard. A pipe fitter who cannot swing a wrench because of a torn rotator cuff, a construction laborer with a herniated disc who cannot lift anything over ten pounds, an oil worker with chemical burns covering his hands: these workers cannot simply wait out a denial. They need income, they need medical treatment, and they need a lawyer who knows how to overturn the insurer's decision at the Van Nuys WCAB.
Insurance companies deny claims for a limited set of reasons, and most denials can be challenged successfully with proper legal representation. The most common grounds for denial include:
The insurer disputes that the injury is work-related. This is the most frequent basis for denial, particularly for cumulative injuries and conditions that can have non-occupational causes. A Newhall plumber with degenerative disc disease may be told his back condition is age-related, not work-related, even though he has spent 20 years crawling under houses and lifting fixtures. An oil worker with respiratory problems may be told his symptoms are due to smoking or allergies rather than years of hydrogen sulfide exposure. A medical-legal evaluation by a Qualified or Agreed Medical Evaluator can establish the work-relatedness of these conditions and overturn the denial.
The insurer claims the injury was not reported timely. Under Labor Code Section 5400, employees must notify their employer of an injury within 30 days. Insurance companies use late reporting to argue that the injury did not actually happen at work or that the delay proves it was not serious. However, late reporting alone is not grounds for denial if the employer was not prejudiced by the delay, and the statute of limitations for filing a claim is one year, not 30 days.
The employer disputes that you are an employee. This is common in Newhall's construction and oil industries, where worker misclassification is widespread. If you were classified as an independent contractor, the insurer may deny your claim entirely. California's ABC test, codified in Labor Code Section 2750.3, provides a framework for establishing employee status, and many workers classified as contractors are in fact employees entitled to full coverage.
The insurer relies on a medical opinion that your injury does not require the treatment being sought. Insurance companies retain physicians through utilization review programs to deny treatment requests. These denials can be challenged through the Independent Medical Review process.
When your claim is denied, you have the right to challenge the denial before the Workers' Compensation Appeals Board. The process involves several steps, and having an attorney at each stage significantly improves your chances of success.
First, your attorney files a Declaration of Readiness to Proceed, which requests a hearing before a workers' comp judge at the Van Nuys WCAB. The case is then set for a Mandatory Settlement Conference, where the parties attempt to resolve the dispute. If settlement is not reached, the case proceeds to trial.
The key to overturning a denial is medical evidence. Your attorney will arrange for an evaluation by a Qualified Medical Evaluator or negotiate the selection of an Agreed Medical Evaluator. This physician reviews your medical records, examines you, and issues a report addressing the specific issues in dispute: whether your injury is work-related, the extent of your disability, and what treatment you need. A favorable medical-legal report can be the single most important piece of evidence in overturning a denial.
Your attorney also gathers lay evidence, including witness statements from coworkers who observed the injury or can testify about your job duties, employment records showing your work history, and documentation of workplace conditions. For Newhall oil workers, this might include safety data sheets for chemicals used on site. For construction workers, it might include project records showing the physical demands of the specific job.
A denied claim puts Newhall workers in an impossible position. Without temporary disability payments, they have no income. Without authorized medical treatment, they either go without care or use personal health insurance, which creates liens that complicate the case later. The financial pressure is designed to make you give up, and for workers living paycheck to paycheck, it works more often than it should.
Small employers in Newhall sometimes contribute to the problem by failing to report injuries properly, discouraging workers from filing claims, or providing inaccurate information to the insurer. An employer who tells the adjuster that the worker was not on the job when the injury occurred, or that the worker has a pre-existing condition, can trigger a denial that would not have happened with accurate reporting.
Yazdchi Law P.C. takes denied claims seriously because we know what is at stake for the worker. Attorney Eman Yazdchi handles every stage of the dispute process, from filing the initial challenge through trial at the Van Nuys WCAB. We advance costs for medical evaluations and depositions, so the worker pays nothing out of pocket while the case is pending.
Injured at work in Newhall? Call (661) 273-1780
Tap to call →Overturning a denied workers' comp claim requires a specific skill set: the ability to read medical reports critically, identify weaknesses in the insurer's position, select the right medical evaluators, and present a compelling case before a workers' comp judge. Eman Yazdchi is a Board-Certified Workers' Compensation Specialist, a credential held by fewer than 1% of California attorneys. This certification exists precisely to identify attorneys with the expertise to handle complex and contested claims like those that come from Newhall's construction sites, oil operations, and trade shops.
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