The Claim, Start to Finish

This is the map. Ten stages, every deadline that governs them, and what actually decides the outcome at each one.

Changed six weeks ago. The Appeals Board's 60-day clock on a petition for reconsideration runs from the date a trial judge transmits the case to the Board — and that is now permanent. The transmittal trigger arrived with AB 171 (Stats. 2024, ch. 52) on July 2, 2024 and was written to expire on July 1, 2026, which would have returned the clock to the date of filing. SB 171 (Stats. 2026, ch. 83), chaptered July 13, 2026, deleted that sunset and repealed the filing-trigger version. Details in Stage 8. Much of the published material in California — including material updated this summer — describes a reversion the Legislature undid.

Every deadline in one table

In a cumulative trauma or occupational disease claim, the "date of injury" is not the date of the exposure. Under § 5412 it is the date you first suffered disability and knew, or should have known, it was work-related. That single rule saves more otherwise-late claims than anything else in the code. How cumulative trauma works.

Stage 1 — Report it

Labor Code § 5400 gives you 30 days to notify your employer.

But § 5402(a) is the safety valve, and it is broad: knowledge of an injury "obtained from any source, on the part of an employer, the employer's managing agent, superintendent, foreman, or other person in authority" is equivalent to formal notice.

So a supervisor who saw it happen is notice. A foreman you told at the time is notice. A first-aid log entry is notice. Missing the 30-day window is not automatically fatal, and workers talk themselves out of valid claims over it constantly.

Report in writing anyway, and keep a copy. Text messages and emails are the best evidence most workers ever generate.

Stage 2 — The claim form

Your employer must give you a DWC-1 claim form within one working day of learning about the injury (§ 5401). Many do not.

You do not have to wait for them. The form is available from the DWC directly. Fill out the employee section, sign it, date it, and deliver it — and keep a copy showing the date. That date starts two clocks that matter more than almost anything else in the claim.

The 90-day presumption

§ 5402(b)(1): "If liability is not rejected within 90 days after the date the claim form is filed under Section 5401, the injury shall be presumed compensable under this division."

And the presumption can only be rebutted by evidence discovered after the 90 days expired.

That is a powerful provision and it is why the filing date must be documented. A carrier that sits on a claim past 90 days has, by statute, largely lost the ability to contest it on what it knew.

The $10,000

§ 5402(c): within one working day after you file the claim form, the employer must authorize treatment for the claimed injury and keep it authorized until liability is determined — limited to $10,000.

This is medical treatment you are entitled to while your claim is being investigated. Read the limit carefully: § 5402(c) says the employer "shall continue to provide the treatment until the date that liability for the claim is accepted or rejected" — so the obligation runs during delay, and a rejection ends it. It is not a fund that survives a denial. It is one of the least-known provisions in California workers' compensation, and workers with delayed claims routinely go untreated because nobody told them.

Stage 3 — Accepted, delayed, or denied

Within 14 days the claims administrator must tell you in writing which one it is.

Accepted — benefits begin.

Delayed — a "delay letter," which is not a denial. Investigation continues, the $10,000 treatment obligation is live, and the 90-day clock is running.

Denied — and a denial is not the end of the claim. It is the beginning of the litigated part of it. What to do about a denial.

Stage 4 — Treatment, and the fight over it

Medical treatment is controlled by the medical provider network in most cases, and by the utilization review process in all of them.

Every request your doctor makes goes to UR. UR either approves it, modifies it, or denies it — and a UR denial can only be appealed through Independent Medical Review, not to a judge, except where the denial was procedurally defective.

The IMR deadline is 30 days from the UR decision and it is short and unforgiving.

Stage 5 — The medical-legal evaluation

When there is a dispute about your injury — causation, extent, apportionment, permanent disability, or whether you can work — it is resolved by a medical-legal evaluation.

Represented workers can agree with the defense on an Agreed Medical Evaluator. Unrepresented workers get a Qualified Medical Evaluator panel from a random draw, with a specialty chosen from the request.

The QME panel process contains the most consequential deadlines in the entire claim, and they run in days, not months. Missing one can cost you the choice of specialty entirely.

How the QME process works, step by step.

Stage 6 — Permanent and stationary, and the rating

When your condition stops improving, you are permanent and stationary — the same thing as maximum medical improvement. The evaluator writes a report assigning whole person impairment under the AMA Guides and stating apportionment.

That impairment number is run through the 2005 Permanent Disability Rating Schedule — adjusted for your occupation, your age, and (for older injuries) a diminished future earning capacity factor — producing a rating string and a final percentage.

The rating string is checkable, and it is checked far too rarely. How to read yours. · How the money is actually calculated.

Stage 7 — Into the litigation track

File the Application for Adjudication within one year (§ 5405). This opens a case at the Appeals Board and gets you an ADJ number and a district office. Which office, and where it actually is.

Then a Declaration of Readiness to Proceed — a filing by either side saying the case is ready for a conference or a trial.

If you receive a DOR, you have 10 calendar days to object. Under 8 CCR 10744, a party served with a DOR who does not object "shall be deemed to have waived any and all objections to proceeding on the issues specified in the declaration, absent extraordinary circumstances."

Ten days. And the waiver is broad.

The Mandatory Settlement Conference is set 10 to 30 days after the DOR (§ 5502(d)). Most cases resolve here.

The most important rule in the whole process

§ 5502(d)(3): "Discovery shall close on the date of the mandatory settlement conference. Evidence not disclosed or obtained thereafter shall not be admissible unless the proponent of the evidence can demonstrate that it was not available or could not have been discovered by the exercise of due diligence prior to the settlement conference."

Whatever is not on the exhibit list at the MSC does not come in at trial.

The parties complete a joint Pretrial Conference Statement identifying the issues, the stipulations, each side's proposed permanent disability rating, every witness, and every exhibit — with author, date, and title for each document (8 CCR 10759).

This is where cases are actually won and lost, and it is invisible to almost everyone outside the system. A missing report, an un-listed witness, a supplemental opinion never obtained — all of it becomes permanent at that conference.

If the case does not settle, trial is set within 75 days of the DOR.

Stage 8 — Trial, and reconsideration

Trial before a workers' compensation judge: testimony, exhibits already disclosed, and argument. The judge issues Findings and Award — or Findings and Order — with an opinion.

Petition for Reconsideration — 20 days

§ 5903 gives 20 days from a final order, decision, or award.

Reconsideration is only available from final orders. A non-final order — a trial-setting order, most discovery rulings — is challenged instead by a Petition for Removal. Filing the wrong one wastes the deadline, and it is a common and expensive error.

And the rule the Legislature made permanent in July 2026

Labor Code § 5909 provides that a petition for reconsideration is deemed denied unless the Board acts on it within 60 days. The trigger for that 60 days changed once, was scheduled to change back, and then was made permanent instead:

In Reed v. County of San Bernardino (significant panel decision, November 5, 2024), the Board held that under the transmittal trigger, the 60 days began when the case appeared as "Sent to Recon" in EAMS.

That analysis construes the trigger that is still operative today.

§ 5909 now reads:

"(a) A petition for reconsideration is deemed to have been denied by the appeals board unless it is acted upon within 60 days from the date a trial judge transmits a case to the appeals board.

(b)(1) When a trial judge transmits a case to the appeals board, the trial judge shall provide notice to the parties of the case and the appeals board.

(b)(2) For purposes of paragraph (1), service of the accompanying report, pursuant to subdivision (b) of Section 5900, shall constitute providing notice."

We are flagging this specifically because a great deal of published material — including material written by people who practice in this system — announced that the filing trigger returned on July 1, 2026. It did not. The Legislature deleted the sunset, and transmittal is the operative and permanent rule.

One open question, and we state it as a question. SB 171 was chaptered on July 13, 2026 — twelve days after AB 171's July 1 sunset date. Which trigger governed a petition acted on inside that twelve-day window is not something we treat as settled, and it is the kind of gap that can decide whether an order was timely. If a petition of yours was pending in early July 2026, that is worth an attorney's attention on the specific dates in your file.

After the Board: a Petition for Writ of Review to the Court of Appeal, within 45 days.

Stage 9 — Settlement

Two structures, and the choice is permanent.

Stipulations with Request for Award. The parties agree on the percentage of permanent disability and it is paid out over time. Future medical treatment stays open. The case can be reopened for new and further disability within five years of the date of injury.

Compromise and Release. One lump sum. Future medical treatment closes permanently. The case does not reopen.

Compromise and Release is the right answer in many cases and a catastrophe in others.

In any case involving a prosthesis, an implanted device, a joint replacement that will need revision, ongoing medication, or a progressive condition, closing future medical without a professionally prepared lifetime cost projection is how a worker ends up paying for their own care later.

Both require approval by a workers' compensation judge, who must find the settlement adequate. A judge can and does reject inadequate settlements, including for unrepresented workers — but the judge is working from the record in front of them, which is frequently the defense's record.

How settlements work, the math, and when a C&R is the wrong choice.

Stage 10 — After it is over

New and further disability. If your condition gets worse, § 5410 permits reopening within five years of the date of injury — not five years from the settlement, and not five years from the award. From the date of injury. For a worker who settled at year four, that leaves twelve months.

The Board's continuing jurisdiction. Under §§ 5803 and 5804, the Appeals Board may rescind, alter, or amend an award for good cause within five years of the date of injury.

And a Compromise and Release generally forecloses this. That is the trade.

If your case is already settled and things got worse.

The five things that go wrong most often

Nobody documents the claim form date. The 90-day presumption and the $10,000 treatment obligation both run from it.

The $10,000 is never used. Workers with delayed claims go untreated for months while an entitlement sits unclaimed.

A DOR is ignored. Ten days, and the objection is waived.

Discovery closes and something is missing. After the MSC, it is generally too late — permanently.

The wrong petition is filed after trial. Reconsideration for final orders, removal for non-final ones, 20 days either way.

Frequently asked questions

What people actually ask about filing

• How do I prove my injury?
• Nobody saw it happen.a witness is not required, and what substitutes for one is mostly within your control
• I was hurt during my break.
• I got sick from something at work.
• I was hurt in California but I don't live here.jurisdiction usually turns on where you were hired, not where it happened
• Every DWC form, and what clock each one starts.