First 30 days: report and file
The clock that matters most starts the day you are hurt. California Labor Code §5400 requires you to report the injury to your employer within 30 days, and §5401 requires the employer to provide you a DWC-1 claim form within one working day of learning about the injury[1]. A late report is one of the easiest grounds the carrier has to question whether the injury actually happened at work.
"Except as provided by Sections 5402 and 5403, no claim to recover compensation under this division shall be maintained unless within thirty days after the occurrence of the injury which is claimed to have caused the disability or death, there is served upon the employer notice in writing..."
— California Labor Code §5400
In the first 30 days, the only goals are: tell your employer in writing, get the DWC-1, complete and return the employee section, and start medical treatment through the MPN if your employer has one. For a fuller checklist, see our first 24 hours guide.
The §5402 90-day investigation period
Once the DWC-1 is filed, the carrier has 90 days to accept or deny the claim. During those 90 days, the carrier is investigating: pulling employment records, ordering medical records, possibly arranging a recorded statement (which you should not give without counsel), and evaluating compensability.
Under California Labor Code §5402(c), up to $10,000 of medical treatment must be authorized during the 90-day investigation period, even before liability is accepted
[2]. That money is meant to keep you treating while the carrier decides — and to discourage carriers from using delay as a substitute for denial.
If the carrier does not deny the claim within 90 days under §5402(b), the injury is presumed compensable, and the presumption can only be rebutted by evidence the carrier could not have obtained with reasonable diligence during the 90-day window
[3]. The 90-day presumption is one of the most powerful statutory protections for injured workers, and it is the reason carriers issue formal denials so aggressively at day 85 or 89. A timely denial preserves their right to litigate; an untimely one largely surrenders it.
Treatment and the road to MMI
After acceptance (or denial — denied claims still need treatment, often paid through group health, with reimbursement claims later), you settle into the treatment phase. This is the longest stretch of any comp case. Your treating physician sees you at intervals, sends RFAs through Utilization Review, and tracks your progress toward MMI.
How long this phase lasts depends almost entirely on the injury. A clean ankle sprain can reach MMI in 8–12 weeks. A lumbar disc injury that requires conservative care, then injections, then evaluation for surgery can run 12–18 months. A complex shoulder case with a failed first surgery and a revision can run 2 years or more. The median single-injury orthopedic case in our practice typically reaches MMI somewhere between 6 and 18 months after the date of injury.
UR denials extend the timeline. A denial of a needed MRI delays diagnosis; a denial of a needed surgery delays MMI. The Independent Medical Review (IMR) appeal takes another 30 days at minimum and sometimes longer, and during that time treatment is on pause. Workers without legal representation are often surprised at how much of their timeline is consumed by treatment authorization disputes rather than by treatment itself.
Most clients ask me how long their case will take. The honest answer is: as long as your body takes to stabilize, plus about a year for the system to catch up to your medical record.
The arrival of MMI changes the case. The treating physician writes a permanent and stationary report, the impairment is rated, and the case shifts from a treatment posture to a settlement posture.
QME or AME evaluation
A medical-legal evaluation is required when there is a dispute the parties cannot resolve through the treating physician — typically a dispute about compensability, body parts accepted, apportionment, MMI status, or the impairment rating itself. The QME and AME process is governed by California Labor Code §§4060 through 4062, which set out who can request a panel, how panels are selected, and the timelines for objection[4].
For represented cases, the parties can either select a QME from a state-issued three-physician panel (each side strikes one) or stipulate to an Agreed Medical Evaluator (AME). AMEs are typically faster and produce more authoritative reports, because both sides have agreed to the evaluator and have less incentive to litigate the result.
The QME or AME schedules an examination, reviews the records (which can run hundreds or thousands of pages), and issues a report. Statutory turnaround for the report is generally 30 days from the examination, though extensions are routinely granted. From RFA to final report, a QME process typically runs 3–6 months. Supplemental reports, deposition of the evaluator, and re-evaluations can add another 3–6 months on top.
Mandatory Settlement Conference
Once medical-legal is complete and the case is at MMI, either party can file a Declaration of Readiness to Proceed. The case is then set for a Mandatory Settlement Conference (MSC). MSCs are typically scheduled 60–120 days after the DOR is filed, depending on the WCAB district office's calendar.
At the MSC, both sides exchange settlement proposals, exhibits, and a Pretrial Conference Statement listing the issues and witnesses for trial. The judge presides over a settlement discussion and, if the case does not settle, sets it for trial. Under California Labor Code §4658, the judge will use the rated PD percentage and the §4658 weeks-of-payment table to value the indemnity portion of the case for settlement purposes[5].
Most cases settle at or shortly after the MSC. A Stipulation with Request for Award keeps medical treatment open for life on the accepted body parts; a Compromise and Release closes future medical for a lump sum. The choice between them is often the single largest decision in the case, and it is worth taking time over.
Trial, reconsideration, and appeals
If the case does not settle, it is set for trial — usually 30–90 days after the MSC. Trial is a bench proceeding before a workers' comp judge: testimony, documentary evidence, and a closing brief. The judge takes the matter under submission and issues a Findings & Award typically 30–90 days later.
Either party can file a Petition for Reconsideration with the WCAB panel within 25 days of the F&A. The panel reviews the trial record and issues a written decision; the typical reconsideration timeline is 60–120 days. Beyond the WCAB, a Petition for Writ of Review can be filed with the California Court of Appeal, but writs are rarely granted in workers' comp cases.
A litigated case from injury to final WCAB resolution typically runs 2–4 years. A case that settles at MSC typically runs 18–30 months. A clean accepted case that settles by Stipulation right after MMI can finish in 12–18 months. The variance is real, and most of it comes from the treatment phase, not the litigation phase. Cases run long because bodies take time to stabilize — the legal system is, mostly, waiting for medicine to settle.
This guide is general legal information, not legal advice. For advice about your specific situation, contact our office.
References
- Cal. Labor Code §§5400, 5401 (notice and claim form) — California Labor Code
- Cal. Labor Code §5402(c) ($10,000 treatment during investigation) — California Labor Code
- Cal. Labor Code §5402(b) (90-day presumption of compensability) — California Labor Code
- Cal. Labor Code §§4060–4062 (QME and AME process) — California Labor Code
- Cal. Labor Code §4658 (PD weeks by rating) — California Labor Code
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Past results do not guarantee similar outcomes. Each case is evaluated on its own merits.