What happens after I file a workers' comp claim in California?

The claims administrator has 90 days to accept or deny it. Under Labor Code section 5402, a claim not rejected within 90 days of the DWC-1 filing is presumed compensable, and while the claim is under investigation the employer must authorize medical treatment up to ten thousand dollars.

Filing the DWC-1 claim form starts a regulated sequence. The employer must forward the claim to its insurer, and Labor Code section 5402 gives the claims administrator 90 days to accept or deny liability; silence past 90 days makes the injury presumptively compensable, rebuttable only with evidence that could not reasonably have been obtained during the investigation. From the day the claim is filed, the employer must authorize appropriate medical treatment while the decision is pending, up to ten thousand dollars (section 5402(c)) — treatment does not wait for acceptance. Accepted claims then flow through the benefit system: temporary disability payments while the worker cannot earn full wages, treatment within the medical provider network, and permanent disability evaluation once the condition stabilizes. Delayed or denied claims move to the dispute track: an Application for Adjudication with the Workers' Compensation Appeals Board and, for medical disagreements, the Qualified Medical Evaluator process under Labor Code section 4062.2. Each step carries its own strict deadlines.

Authority: Cal. Lab. Code § 5402