San Diego Claim Denial & Appeals Lawyer
We Know How Insurers Deny Claims. We Use That Against Them.
A denied workers’ compensation claim doesn’t have to be the end of the road. California requires employers with at least one employee (full-time or part-time) to carry workers’ compensation insurance, and the system is deliberately no-fault. Injured workers don’t need to prove their employer was negligent to qualify for benefits. Yet denials happen constantly, cutting workers off from the medical coverage and wage replacement they need most.
At Leigh Law Firm, founded by Alexander J. Leigh, Esq., our team includes a former defense attorney who spent years on the insurer’s side of these disputes. We know the specific criteria adjusters use to flag claims, the medical review shortcuts that can produce questionable denials, and the technicalities insurers lean on when a straightforward refusal won’t hold up. That background is a direct advantage for San Diego workers whose claims have been denied.
Common grounds for denial in California include:
- Scope of employment disputed: The insurer alleges the injury happened outside the course of work
- Disability not established: A health provider’s evaluation concludes the worker isn’t disabled as a result of a work injury
- Pre-existing condition apportionment: The insurer attributes the condition to prior health history rather than work activity
- Disputed timing or location: When or where the injury occurred is contested
- Existence of injury disputed: The insurer denies that an injury occurred at all
- Late reporting: The worker didn’t report the injury within the required timeframe
- Inconsistencies in records: Alleged discrepancies between the injury report and medical documentation
- Administrative errors: Incomplete paperwork or procedural missteps used to justify denial
If your workers’ compensation claim was denied, contact Leigh Law Firm at (619) 473-7569 for a free consultation. We handle cases on contingency. No fees unless we recover compensation for you.
"He explained in detail what to expect during the process and always there to answer any questions I might have for my case."He explained in detail what to expect during the process and always there to answer any questions I might have for my case.
- Tim B.
