Workers' Comp Claim Timeline: How Long Does It Take?
One of the most common questions injured workers ask is: "How long will this take?" The honest answer is that the average California workers' comp claim takes 12 to 24 months from injury to settlement. This guide breaks down every phase of the process so you know exactly what to expect, what affects the speed of your case, and how to avoid unnecessary delays.
The Complete Workers' Comp Timeline
A workers' comp claim moves through six distinct phases. The duration of each phase varies based on the severity of your injury, whether the insurer disputes anything, and whether you need surgery. Below is a detailed breakdown of each phase with typical timeframes.
The clock starts the moment you are injured. Under Labor Code §5400, you must report your injury to your employer within 30 days. However, for the strongest possible claim, report it immediately -- the same day if possible. Delayed reporting is one of the top reasons insurers use to deny claims.
Key Steps in This Phase:
- Report injury to supervisor (immediately)
- Seek medical treatment (same day or next day)
- Employer provides DWC-1 claim form (within 1 working day)
- Complete and return DWC-1 form
- Insurer begins investigation (within 14 days of receiving claim)
The insurance company has 90 days to accept or deny your claim. During this investigation period, they will review medical records, interview witnesses, and potentially have you examined by their own doctor. Importantly, the insurer must authorize up to $10,000 in medical treatment during this period even before formally accepting the claim.
What Happens During Investigation:
- Insurer reviews medical records and injury report
- May schedule you with their doctor for an exam
- Temporary disability payments begin (if claim accepted or under investigation)
- Medical treatment authorized (up to $10,000 during investigation)
- Formal acceptance or denial letter issued
Important: The 90-Day Presumption
If the insurer fails to accept or deny your claim within 90 days, the claim is presumed accepted under California law. This is a powerful protection for injured workers. Some insurers try to delay their investigation hoping the worker will not follow up. Always track the 90-day deadline and hold the insurer accountable.
This is typically the longest phase of a workers' comp case. Treatment continues until your doctor declares you at Maximum Medical Improvement (MMI), also called "permanent and stationary" (P&S). MMI means your condition has stabilized and further treatment is unlikely to produce significant improvement. For simple injuries, this may take 3-6 months. For surgical cases, 12-24 months is common.
Typical Treatment Timelines:
- Sprains/strains (no surgery): 2-6 months to MMI
- Fractures: 4-12 months to MMI
- Disc herniation (no surgery): 4-9 months to MMI
- Single surgery (discectomy, rotator cuff repair): 9-18 months to MMI
- Major surgery (spinal fusion, joint replacement): 12-24+ months to MMI
While you are recovering and unable to work (or working reduced hours), you receive temporary disability (TD) benefits. Under Labor Code §4656, TD is capped at 104 weeks within a 5-year period for most injuries. TD payments are two-thirds of your pre-injury average weekly wage, subject to minimum and maximum rates.
2026 TD Benefit Rates:
- Minimum: $265.00 per week
- Maximum: $1,764.00 per week
- Rate: Two-thirds (66.67%) of your average weekly earnings
- First payment due: Within 14 days of employer's knowledge of injury (under Labor Code §4650)
For a deeper dive into TD vs. PD benefits, see our guide on temporary vs. permanent disability.
Once you reach MMI, the next step is determining your permanent disability (PD) rating -- the percentage that quantifies how much your injury permanently affects your ability to work. Your treating physician may issue a report, but most cases involve a Qualified Medical Evaluator (QME) for an independent assessment. The QME process takes time: selecting from a panel, scheduling the appointment, the exam itself, and waiting for the report.
QME Process Timeline:
- Panel request to selection: 2-4 weeks
- Scheduling the appointment: 2-8 weeks (varies by specialty and location)
- QME exam: 1-3 hours (single appointment usually)
- Report issuance: 30-60 days after exam
- Supplemental reports (if needed): Additional 30-60 days
For a detailed explanation of the PD rating process, read our guide on how your PD rating is calculated.
The final phase is negotiating and finalizing the settlement. With a PD rating in hand, your attorney and the insurer negotiate the terms. If they cannot agree, the case proceeds to the WCAB for a Mandatory Settlement Conference (MSC) and potentially trial. Most cases settle before trial, but the process can take several months to a year.
Settlement Process Steps:
- Initial demand/offer exchange: 2-4 weeks
- Negotiation rounds: 1-4 months
- MSC (if needed): Scheduled 2-4 months after DOR filing
- Trial (if settlement fails): 2-6 months after MSC
- Settlement approval by WCAB judge: 2-4 weeks
- Payment after approval: 30 days
Total Timeline Summary
The following table summarizes typical total timelines based on case complexity:
| Case Type | Typical Total Timeline | Key Characteristics |
|---|---|---|
| Simple / No Surgery | 6 - 12 months | Minor injury, accepted claim, conservative treatment, quick MMI, no disputes |
| Moderate / One Surgery | 12 - 24 months | Surgery needed, standard QME process, negotiated settlement, minimal disputes |
| Complex / Multiple Issues | 24 - 48 months | Multiple surgeries, denied claim, disputed PD rating, apportionment fight, MSC/trial needed |
| Denied & Appealed | 18 - 36 months | Initial denial, QME to establish causation, WCAB hearing, then standard settlement process |
What Factors Speed Up or Slow Down Your Case?
Factors That Speed Up Resolution
- Immediate reporting: Reporting your injury on the day it happens eliminates any question about when the injury occurred and prevents the insurer from arguing delayed reporting
- Accepted claim: When the insurer accepts your claim without dispute, treatment begins faster and the case moves through each phase more smoothly
- Consistent medical treatment: Attending all appointments and following your treatment plan builds a strong medical record and helps you reach MMI sooner
- Experienced attorney: An attorney who knows the system can anticipate delays, push back on insurer stalling, and manage deadlines to keep the case moving
- Clear liability: When the work-relatedness of your injury is obvious (witnessed accident, immediate symptoms), the insurer has less room to dispute and delay
Factors That Slow Down Resolution
- Claim denial: A denied claim adds 6-18 months to the timeline while you fight for acceptance through the QME and WCAB processes
- Surgery delays: Insurance companies frequently delay surgical authorization through Utilization Review denials, adding 2-6 months per denied surgery
- Multiple surgeries: Each additional surgery extends the treatment phase and delays MMI. Some workers need 2-3 surgeries before reaching MMI
- Apportionment disputes: When the insurer argues that part of your disability is non-industrial, resolving the dispute adds months to the settlement phase
- QME backlogs: In some specialties and regions, QME appointment wait times can be 2-4 months or longer
- WCAB calendar congestion: WCAB hearing dates may be scheduled months in advance, especially in busy jurisdictions like Los Angeles
The Statute of Limitations: Critical Deadlines
California imposes strict deadlines for filing workers' comp claims. Missing these deadlines can permanently bar your claim:
- 30 days to report: Under Labor Code §5400, you must report your injury to your employer within 30 days. For cumulative trauma injuries, the 30-day clock starts when you knew (or should have known) the injury was work-related.
- 1 year to file: Under Labor Code §5405, you have one year from the date of injury to file a workers' comp claim with the WCAB. For cumulative trauma, the one-year period begins when you first suffered disability and knew or should have known it was caused by your work.
- 5-year jurisdiction: The WCAB retains jurisdiction over your case for 5 years from the date of injury. After 5 years, you generally cannot reopen the case for new or further disability (with limited exceptions).
What to Expect at Each Key Appointment
The QME Evaluation
The QME appointment is typically a 1-3 hour examination with a physician who specializes in evaluating workplace injuries. The QME will review your complete medical file, examine you physically, test your range of motion, and ask detailed questions about your symptoms, work duties, and limitations. Come prepared to describe your worst days, bring a list of all medications, and have a detailed job description available.
The Mandatory Settlement Conference (MSC)
If your case does not settle through direct negotiation, a Mandatory Settlement Conference is scheduled at the WCAB. Both your attorney and the insurer's attorney appear before a workers' comp judge who attempts to facilitate a settlement. Many cases resolve at the MSC. If not, the judge sets the case for trial.
Trial
Workers' comp trials are bench trials -- decided by a judge, not a jury. The judge hears testimony, reviews medical reports, and issues a decision called a Findings & Award. Trials are relatively brief compared to civil court trials, typically lasting a few hours to a few days. The judge's decision can be appealed to the Workers' Compensation Appeals Board.
A Step-by-Step Guide to Your First 48 Hours
The first two days after your injury set the tone for your entire case. For a detailed walkthrough of what to do immediately, see our guide on the first 48 hours after a workplace injury. For a comprehensive overview of the entire workers' comp process, visit our complete workers' comp guide.
Pro Tip: Track Everything
Keep a written log of every doctor appointment, phone call with the insurer, and TD payment received. Note dates, names, and what was discussed. This log becomes invaluable if there are disputes about delays, missed payments, or communication breakdowns. Many workers' comp cases involve disagreements about what was said and when -- a contemporaneous written record is your best protection.
Frequently Asked Questions
How long does the average workers' comp claim take in California?
The average California workers' comp claim takes 12-24 months from injury to final settlement. Simple claims with minor injuries and no disputes can resolve in as few as 6-9 months. Complex cases involving surgery, disputed liability, QME evaluations, and contested PD ratings can take 2-4 years or longer. The biggest factors affecting timeline are whether surgery is needed, whether the insurer disputes the claim, and how quickly you reach Maximum Medical Improvement.
How long does the insurance company have to accept or deny my claim?
Under California Labor Code §5402, the insurance company has 90 days from the date you file your claim to accept or deny it. During this 90-day investigation period, the insurer must provide up to $10,000 in medical treatment regardless of whether the claim has been formally accepted. If the insurer fails to accept or deny within 90 days, the claim is presumed accepted.
Can I speed up my workers' comp case?
There are several ways to keep your case moving: report your injury immediately, attend all medical appointments, follow your treatment plan, be responsive to requests for information, and have an attorney who aggressively manages deadlines. You cannot rush the medical process -- you must wait until you reach MMI for an accurate PD rating -- but you can avoid unnecessary delays by staying proactive and having legal representation that knows the system.
How long does temporary disability last in California?
Temporary disability benefits are capped at 104 weeks (2 years) within a 5-year period from the date of injury for most conditions. There are exceptions: certain injuries like severe burns, hepatitis B or C, HIV, and amputations can receive up to 240 weeks of TD. The 104-week cap is the total -- if you return to work and then need to stop again due to the same injury, those additional weeks count against your total.
What happens if my case takes longer than expected?
Delays are common and do not necessarily mean something is wrong. However, unjustified delays by the insurance company can result in penalties of up to 25% on delayed benefits. If your case is taking longer than expected, common reasons include: the insurer is stalling on authorizing treatment, the QME process is backlogged, settlement negotiations are at an impasse, or your medical condition has not stabilized. An experienced attorney can identify the cause of delays and take action to move your case forward.
Not Sure Where You Stand in the Process?
Whether you just got injured, are waiting for a surgery authorization, or are stuck in settlement negotiations, a free consultation can clarify exactly where you are in the process and what comes next. We will review your case, identify any delays or problems, and give you an honest timeline estimate for resolution.
Legal Disclaimer: The timelines discussed in this article are estimates based on typical California workers' compensation cases. Your case may resolve faster or slower depending on the specific circumstances, including the severity of your injury, whether the claim is disputed, the insurer's cooperation, and the WCAB's caseload in your jurisdiction. This article is general information and not legal advice. Contact our office for a free consultation about your specific case.
David Lamonica (State Bar #165205) has guided thousands of injured workers through the California workers' comp system. He understands the timeline frustrations workers face and fights to keep cases moving by holding insurers accountable for delays.