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What should I do if my workers' comp claim is denied?

Updated July 1, 2026United States

Short answer

Don't panic, and don't miss the deadline — a denial is often not the end, and many are appealable. Read the denial letter for the specific reason and the deadline to respond, keep getting the medical care you need, gather documentation that answers the stated reason, and file an appeal (or request a hearing) with your state's workers' comp board in time. Appeal steps and deadlines vary by state, so check the letter and your state's board — and consider a workers' comp attorney, as many offer a free consultation.

A denial letter feels final. Usually it isn't — it's the start of an appeal with its own clock. Move on the clock first, then on the reason.

Step by step

  1. Read the denial letter carefully — find the reason and the deadline

    The letter should state why the claim was denied and how (and by when) you can challenge it. That deadline is the single most important thing on the page — note it immediately, because missing it can cost you the appeal regardless of how strong your case is.

  2. Identify the specific reason

    Denials usually turn on a specific point — for example, a dispute over whether the injury is work-related, a missed reporting deadline, not enough medical evidence, or a pre-existing condition. Your response should target that exact reason, so be clear on what it is.

  3. Keep getting the treatment you need

    A denial doesn't mean you should stop caring for your injury. Continue treatment and keep documenting it — ongoing medical records are often exactly the evidence an appeal needs, and stopping can be used to argue the injury wasn't serious.

  4. Gather evidence that answers the reason given

    Pull together what speaks directly to the denial: medical records, your dated log of what happened, witness names, and any correspondence. If the issue is "not work-related," focus on evidence of how and when it happened; if it's "insufficient medical evidence," focus on the records.

  5. File the appeal or request a hearing in time

    Follow the process in the letter, or on your state's workers' comp board (a .gov site), to formally appeal or request a hearing before the deadline. The process and the body that hears it vary by state, so use your state's official source rather than a general description.

  6. Consider getting an attorney

    Denied claims are where many people bring in a workers' comp attorney. Many offer a free first consultation and are commonly paid only out of any award they recover — though how those fees work is regulated and varies by state. It's worth at least a conversation before an appeal deadline.

  7. Keep documenting through the whole appeal

    Every call, letter, appointment and deadline during the appeal is part of the record. Keeping it organized as you go makes each next step — and handing things to an attorney — far easier.

Plain-English terms

Notice of denial
The letter from the insurer stating your claim is denied. It should give the reason and the deadline and steps to challenge it — read it closely and keep it.
Appeal / request for hearing
The formal way to challenge a denial, usually through your state's workers' comp board. The exact process and deadline are set by your state.
Workers' comp board / commission
The state agency that oversees workers' comp claims and disputes. It's where appeals are typically filed and heard, often before an administrative judge.
Pre-existing condition
A prior injury or condition, sometimes cited as a reason to deny. In many states a work injury that worsens a pre-existing condition can still be covered — but this varies, so check.
Contingency fee
An arrangement where an attorney is paid out of what they recover for you, rather than up front. In workers' comp these fees are regulated and the limits vary by state.

Related questions

This is general information to help you keep your own records — not legal advice. Appeal processes, deadlines and attorney-fee rules vary by state — check the denial letter and your state's workers' compensation board (a .gov site), and consider speaking with a qualified attorney.