If you’ve been injured in the workplace, your employer has probably referred you to a workers’ compensation doctor. But what if that doctor tells you there’s nothing wrong with you? Is that true? Do you need a second opinion?
Many injured workers don’t realize they have legal and medical options—and they can push back against employers and doctors who insist there’s no injury and no workers’ compensation claim. It’s common for this to happen, and you don’t have to deal with an injury without compensation.
Workers’ compensation is a legally mandated insurance system that provides benefits to employees who suffer job-related injuries or illnesses. Under California Labor Code Section 3600, employers are required to provide medical care, temporary or permanent disability payments, and other benefits.
A workers’ compensation doctor is a medical provider who evaluates, diagnoses, and treats injuries under your employer’s insurance plan. In California, these providers are chosen from a Medical Provider Network (MPN)—a pre-approved list maintained by the insurance company.
It’s not uncommon for doctors aligned with insurers to dismiss or minimize injuries—especially when diagnostic tests don’t immediately show abnormalities. This can happen in cases like soft tissue injuries, psychological trauma, or repetitive stress.
This does not mean you’re not injured. It simply means you may need a more comprehensive evaluation by a doctor who will truly advocate for your health and recovery.
If your treating doctor says nothing is wrong but you’re still in pain, you’re legally allowed to seek another opinion from a different physician within your MPN.
Injuries aren’t always physical. California law recognizes psychological injuries—such as anxiety, PTSD, or depression—resulting from workplace incidents like harassment, violence, or trauma.
Yet, these are often the most denied claims due to their subjective nature. You’ll need supporting documentation from a psychiatrist or psychologist within your MPN or through a QME.
Pro tip: Document emotional distress, work disruptions, and any related therapy sessions or medications.
The type and accuracy of your diagnosis determine the benefits you are eligible to receive. Misdiagnosis or a lack of diagnosis can lead to denied benefits, reduced settlements, or unnecessary delays.
A misjudged diagnosis may lower your impairment rating, leading to a lower settlement or denial of PD benefits.
Understanding your rights helps you know what compensation to expect and what steps to take if denied.
Each benefit is calculated with formulas based on your injury, wages, medical findings, and QME or P&S (Permanent and Stationary) report.
If your workers’ comp claim is denied, do not accept it as the final word. You have the right to appeal and request a formal hearing before the Workers’ Compensation Appeals Board (WCAB).
At Michael Burgis & Associates, we’ve helped over 2,000 California workers reverse denied claims and secure the benefits they were entitled to. When the system seems stacked against you, legal expertise is your strongest ally.
We work on a no-win, no-fee basis, meaning there is no upfront cost to hire us. We only get paid if you win.
You can request another MPN physician or file for a QME. It’s your legal right to challenge medical findings.
In California, QME is state-approved and part of the dispute resolution process. Insurers typically hire an IME and may not always be neutral.
Yes. Delayed symptoms, especially in soft tissue or mental health injuries, are recognized in CA law—but documentation is critical.
It’s based on your impairment rating, age, occupation, and diminished future earning capacity—formulas outlined in the PDRS.
This section governs disputes over treatment, diagnosis, and disability. It allows you to request a QME to resolve conflicts between you and the insurance company.
You don’t have to face this alone. At Michael Burgis & Associates, we’re committed to:
Free case evaluation
No out-of-pocket costs
Thousands of successful claim reversals
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"Michael told me that he was going to do the best he can for me, my family, and for my future needs. He's surrounded by a staff. A staff so excellent they're very knowledgeable, professional, and very kind, courteous ... If you're really serious in a workman's comp case what can I say Michael Burgis is the guy. His staff will treat you right, you'll go in the right direction and I guarantee you will win."
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