In this guide8 sections
Missing one workers’ comp appointment in California usually won’t end your claim on its own, but it can delay your care, slow down your case and give the insurer an argument that you aren’t cooperating. The risk is highest for medical-legal exams such as a QME or AME evaluation, and when you repeatedly miss or refuse exams after a written request. If you miss an appointment, reschedule right away, explain why in writing and keep proof.
Key takeaways
- A single missed treatment visit generally doesn’t cut off benefits, but it can delay care and reports that your temporary disability depends on.
- If you refuse or fail to attend an exam after a written request from your employer, your right to pursue compensation can be suspended until you comply (Labor Code §4053).
- QME and AME appointments can’t be canceled or rescheduled less than six business days before the exam without good cause, and cancellations must be in writing.
- If the insurer stops your temporary disability, it must send a written notice explaining why, with an accounting of what it paid.
- Reschedule quickly, document your reason and ask for written confirmation of the new date.
Not all appointments carry the same risk
| Appointment | What it’s for | Risk of missing it |
|---|---|---|
| Treating doctor visit | Ongoing care, work status reports and treatment requests | Delays treatment and the work status reports needed to keep temporary disability going |
| QME or AME evaluation | Medical-legal report on disputed issues such as causation, disability or future care | Delays the report that drives your case; may lead to cancellation fees or disputes over good cause |
| Exam requested by the employer in writing | Periodic exam by a doctor the employer selects and pays for (Labor Code §4050) | Refusing or failing to attend can suspend your right to pursue compensation while the refusal lasts (Labor Code §4053) |
| Exam ordered by the appeals board | Exam ordered by a workers’ comp judge | Disability payments that would accrue during the refusal can be barred (Labor Code §4054) |
| Deposition or hearing | Testimony or a court date in your case | Can delay your case or lead to orders against you; contact your attorney or the court right away |
If you have a deposition coming up, see what to expect at your workers’ comp deposition.
Missing a treating doctor appointment
Your primary treating physician decides whether you can work, what restrictions you have and what treatment to request. Temporary disability is generally paid when a doctor says you can’t work, or your employer can’t accommodate your restrictions. If you miss visits, your work status can go stale and treatment requests may not be submitted.
One missed visit for a good reason is rarely a problem if you reschedule quickly. A pattern of missed visits can lead to delays, a claim that you’ve stopped treating, or arguments about your credibility. If transportation is the problem, tell the adjuster in writing: travel to medical appointments is generally reimbursable, as explained in mileage reimbursement for workers’ comp appointments. If the doctor isn’t working out, you may be able to change; see changing your primary treating physician.
Refusing treatment is a separate issue. Compensation can be denied for disability caused, continued or aggravated by an unreasonable refusal of medical or surgical treatment, but only if the appeals board finds, based on expert evidence, that the risk of the treatment is inconsiderable in view of the seriousness of the injury (Labor Code §4056). Missing an appointment because you were sick is not the same as refusing care.
Missing a QME or AME exam
Medical-legal exams often take months to schedule, so missing one can set your case back significantly. The QME rules provide:
- Neither you, the insurer nor either attorney may cancel or reschedule less than six business days before the appointment without good cause.
- Cancellations must be in writing, state the reason and be served on the other side. A phone cancellation must be confirmed in a letter faxed or mailed no later than 24 hours afterward.
- You aren’t liable for a missed appointment fee when the appointment was canceled for good cause.
- The evaluator, too, can’t cancel within six business days without good cause, and must reschedule within 60 days unless the parties agree in writing.
These rules come from Cal. Code of Regs., tit. 8, §34. If you have an attorney, the law also says you “shall not unreasonably refuse to participate in the evaluation” (Labor Code §4062.2(d)). If you don’t have an attorney and fail to schedule a panel QME within 10 days of the panel issuing, the insurer may choose the doctor (Labor Code §4062.1(c)). For more on the panel process, read how to choose the right QME.
Can the insurer stop your checks?
An insurer may try to stop or suspend temporary disability after a missed exam, especially an exam it requested in writing. But it must follow the rules. When temporary disability ends, the claims administrator must send a notice with the last payment (or within 14 days after it, if the decision came later) explaining why payments stopped, with an accounting of what was paid and a copy of any medical report it relied on (tit. 8, §9812).
If benefits are unreasonably delayed or refused, the payment can be increased by up to 25% or $10,000, whichever is less (Labor Code §5814). Learn more about temporary disability benefits.
Here is a hypothetical. Lena misses a Monday appointment with her treating doctor because her child is sick. She calls that afternoon, reschedules for Thursday, and sends the adjuster a short email explaining what happened and confirming the new date. Her work status report is updated Thursday and her checks continue. Had she skipped several visits without explanation, the insurer would have had a much stronger argument to delay her benefits.
What to do if you miss an appointment
- Call the doctor’s office the same day and reschedule at the earliest date you can attend.
- Tell the adjuster in writing, or tell your attorney, so they can notify the insurer. Explain the reason briefly.
- Keep proof of your reason, such as an urgent care note, a tow receipt or a school notice.
- Get written confirmation of the new appointment.
- Save your records: call logs, texts, emails and calendar screenshots.
- Watch your mail for any benefit notice, and respond quickly if one arrives.
Reasons that are often accepted include illness, a family or medical emergency, a car breakdown, lack of transportation the insurer failed to provide, a scheduling error by the office, or a conflicting court date. Simply forgetting is harder to excuse, so set reminders.
Frequently asked questions
Will missing one appointment end my workers’ comp claim?
Generally no. A single missed appointment with a valid reason that you promptly reschedule rarely causes lasting harm. Repeated or unexplained absences are what create problems.
Can the insurer cut off my temporary disability for a missed QME exam?
It may try, and refusing a properly requested exam can suspend your rights while the refusal lasts. But the insurer must send a written notice explaining why payments stopped, and unreasonable delays can carry a penalty.
Do I have to pay for a missed QME appointment?
The QME rules say you aren’t liable for a missed appointment fee when the appointment was canceled for good cause. Give notice in writing and as early as possible.
What if I can’t get to the appointment?
Tell the adjuster in writing before the appointment. Travel costs to medical appointments, including QME exams, are generally reimbursable, and you can ask the adjuster in writing to cover them ahead of time.
Where can I get free help?
The DWC’s Information and Assistance Unit answers questions for injured workers at no charge.
Talk to a California workers’ comp lawyer
Employees First Labor Law represents workers exclusively in workers’ compensation and employment cases across California. If your benefits were stopped after a missed appointment, we offer free virtual consultations. Contact us online or call (310) 853-3461.
This article is general information about California law as of 2026, not legal advice for your situation. Reading it does not create an attorney-client relationship.
