It is not uncommon to have your workers' compensation claim denied. The California workers' comp system is designed to provide a stringent evaluation of each claim and even the smallest oversight can disqualify a submission. Even when workers' comp benefits are rewarded, it is possible that they do not cover the full scope of the treatment claimant needs to fully recover from their injury.
In these cases, an appeal may be necessary. Below, we take a closer look at this process, the requirements of fighting to having your workers' comp claim recognized, and why having experienced legal counsel by your side gives you the best chance of securing the benefits you deserve.
California Workers' Compensation Appeals Board Hearing
The first step in the appeals process is to request a trial (or hearing) with a California Worker’s Comp Appeals Board (WCAB). At this stage, the applicant and their counsel can argue for why they believe the WCAB determination of their claim was wrong and why the claim deserves further consideration.
The claimant and their counsel can provide documentation to support their claim. However, if the appeals board judge rules to uphold the original determination, further action is needed to appeal the decision.
Petitioning to the Higher California Workers' Compensation Appeals Board (WCAB)
If you were personally handed the WCAB's judgment of your case, you have 20 days to file for reconsideration (you have 25 days if you later receive your decision in the mail). You can do this by filing a Petition for Reconsideration to the higher WCAB located in San Francisco.
It is very important that this petition paperwork is filled out carefully. Your counsel can assist you in making sure that you only provide relevant information and that the petition compellingly illustrates why the appeals judge's decision was inappropriate.
Once the WCAB in San Francisco receives your petition, the appeals board there has 60 days to assess it and make a decision. This usually occurs without a hearing (which is why the documentation is so critical) and the claimant is notified of its decision via the mail.
Appeal to State Appellate Court
If the WCAB decision is still unsatisfactory, a claimant can still request a writ of review of the state appellate court within 45 days of the decision. California Labor Code Section 5950 provides that the state appellate court can step into the workers' comp process and decide whether or not the reasoning behind the WCAB's decision is sound.
Note that the State Appellate Court does not have the power to award benefits. In this case, they can only send the case back to the WCAB for further consideration. In very rare cases, an unsatisfactory State Appellate Court can open a window for an appeal to the California Supreme Court, but that court seldom considers these cases.
Call the Law Offices of Wax & Wax Today
If your workers' compensation claim was denied, or you were awarded insufficient benefits, we invite you to contact us at the Law Offices of Wax & Wax today. Our award-winning Glendale attorneys are well-aware of the challenges claimants face during the appeals process and have time and time again helped our clients navigate this process towards recovering the benefits they deserve.