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How to Appeal Workers’ Compensation Decision

Anytime a person sustains workplace injury, they should be able to receive compensation for their medical bills and lost wages if they are unable to work as a result of the injury. However, there are times when workers’ compensation claims are denied or when the insurance carrier does not offer a sufficient amount of compensation. Here, we want to review the steps that you can take to appeal a workers’ compensation decision that you disagree with.

Petition for Reconsideration

You must first file a Petition for Reconsideration with the Worker’s Comp Appeals Board (WCAB) in the local district where your case was heard. Please move swiftly at this point because you will only have 20 days from the date you receive a decision about your workers’ compensation award from the local office to file this petition.

However, if the decision was mailed to you as opposed to handed to you personally, you will have 25 days from the decision date.

Individuals should only file a Petition for Reconsideration if they believe the evidence related to their work injury case does not support the judge’s decision or the total award, or if they have discovered new evidence that was not available before the original hearing.

We strongly suggest working with a skilled work injury lawyer to help with this Petition for Reconsideration. These forms can get complicated. There is a space for a statement of facts on this petition where individuals should include all of the issues they want the appeals board to consider. This includes why you disagree with the initial decision and why the decision should be changed.

After filing the Petition for Reconsideration, the appeals board will have 60 days to accept or deny it. If the appeals board does not act within 60 days, this is considered a denial of the appeal. If the appeals board accepts the petition to review the claim, they will either affirm, reject, or mend the original decision.

State Appellate Court

If either party is unhappy with the WCAB’s decision after the first appeal, the workplace injury victim or the insurance carrier are allowed to appeal that decision to the state appellate court for review. The appellate court’s Ability to change the decision is limited. They are not allowed to reverse any findings of fact made by the appeals board, and they can only consider whether or not the appeals board decision was reasonable based on the facts that they had. The state appellate court rarely overturns a decision by the WCAB.

If you do want to move forward with an appeal with the appellate court, you must file the writ of review within 45 days of the petition for reconsideration being received.

California Supreme Court

The final option available is filing an appeal with the California Supreme Court, but it is very unlikely that the court will hear any workers’ compensation appeal case.

Working With an Attorney

It is crucial for individuals who sustain workplace injuries to seek assistance from a skilled attorney as soon as possible. The most likely place where a person will alter the decision made by the insurance carrier is through the initial petition for reconsideration process. A San Bernadino workers’ compensation attorney will fully investigate the facts of the case and work diligently to help their client obtain the benefits they are entitled to.