There is always the possibility that a workers’ compensation claim will be denied by your employers’ insurance provider. We understand just how stressful of a situation this can be. Here you are attempting to recover from a work-related injury when you’re faced with the harrowing question of: What do I do now? The good news is that a denial does not necessarily mean a final verdict. There are ways to appeal this decision and overturn the judgement. 

At Jones Legal, we handle all aspects of workers’ compensation, including appeals. We have experience dealing with everything from filing the initial claim to appealing them if and when they are denied. To ensure you have the best chance at appealing your denied workers’ compensation claim, contact Riverside attorney Jennifer Jones as soon as possible.

Workers’ Compensation Appeals Board

When an employee seeks to appeal a denial of workers’ compensation in California, they must go through the Workers’ Compensation Appeals Board (WCAB). The WCAB is a judicial body that reviews petitions for the reconsideration of the decision made by the workers’ comp administrative law judges. In addition, they are responsible for regulating the judgement process by way of adopting rules of practice and procedure.

The WCAB consists of seven members, all appointed by the Governor and approved by the Senate. At least five of the seven WCAB members must be attorneys administered to practice law in that specific state. Each state possesses its own regulations regarding workers’ compensation matters. The California Workers’ Compensation Appeals Board bases most of their judgements off the statutes found in sections 110-138.2 of the Labor Code.

Workers’ Compensation Appeals Process

Before your case sees the Workers’ Compensation Appeals Board, it must go before a workers’ compensation judge. The workers’ compensation judge, or WCJ, may either approve or deny your claim. If it is denied, you possess the right to appeal that decision. Only then will your case be brought before the WCAB.

The WCAB will render a decision in your case. There are a few potential outcomes. These include a final denial, a petition dismissal, reconsideration with a decision, approval of the appeal, or reconsideration with future proceedings.

If the WCAB does not believe your appeal has any validity, they may simply deny it. You are able to file an additional appeal, but it is less likely to be approved. Meanwhile, if the board dismisses your appeal, it doesn’t necessarily mean they are denying it. Rather, they are removing the appeal from consideration at the time. This may be done for a variety of reasons. Your attorney can better explain to you why your petition might’ve been dismissed.

If the appeals board renders reconsideration with a decision, they have made a final decision based on the information they were provided. This may mean they approved the appeal and your workers’ compensation claim, or they may decide your case requires additional hearings with a different WCJ.

If more evidence comes to light, meaning you’ve gathered more in-depth medical information or your injuries have progressively gotten worse, the WCAB may decide on reconsideration with future proceedings. This essentially means that your claim will go through proceedings and hearings once again.

How Long Does a Workers’ Compensation Appeal Take?

If your initial workers’ comp claim was denied, going through the appeal process may take some time. There are many factors that determine how long you can expect for your appeal to be heard. Some of these factors include but are not limited to:

  • The complexity of your case
  • The efficiency of your attorney
  • When you receive medical evaluations
  • If witnesses are contacted in a timely manner
  • The availability of the WCAB

With all things considered, it may take anywhere from a few weeks to several months before your appeal makes it to a hearing in front of the board. It is important that you remain patient during this time. Your attorney will make sure everything is moving as quickly as possible on your end, but the rest is up to the WCAB. Take the time to work with your lawyer to gather as much evidence as you can to support your case.

Contact Jones Legal – Experienced Riverside Workers’ Compensation Appeals Attorneys

To give your appeal the best chance of being approved, you’ll need to make sure you have enough evidence to back up your claim. This may include medical records, witness statements, photographs of the site of the accident and/or your injuries, and anything else that might help prove your work-related injury. Leave it to us at Jones Legal to collect this evidence and more to ensure you have the best chance of successfully overturning your denied workers’ comp claim. We will aggressively fight for your right to compensation for the injuries you sustained on the job. Contact us today to see what we can do for you and your case.