Workplace injuries can be life-changing and even cause permanent damage. Fortunately, workers' compensation insurance is there to help cover medical bills and lost wages while employees get back on their feet. But what happens if a claim is denied or disputed? The workers' compensation appeals process can be confusing and overwhelming, but it's essential to understand if necessary. In this blog post, we'll go over how to appeal a workers' compensation claim denial or dispute.
Step 1: File a Claim for Benefits
If you've been injured on the job, the first step is to file a claim for benefits with your employer or their insurance company. The claim should include information on when and how the injury occurred and details about the medical treatment you've received. If a claim is denied or only partially approved, you can move on to the next step in the appeals process.
Step 2: Request a Hearing
The next step is to request a hearing with the Workers' Compensation Appeals Board (WCAB). This should be done within a specific time frame after a claim is denied or disputed. At the hearing, you'll present evidence of the injury and any medical treatment you've received. The insurance company will also show their side of the story. A WCAB administrative judge will then decide on the claim.
Step 3: Petition for Reconsideration
If either party is unhappy with the WCAB administrative judge's decision, a petition for reconsideration can be filed. This must be done within a specific time frame, and include why you believe the decision was incorrect. A panel of three WCAB commissioners will review this petition.
Step 4: File a Petition for Review
If a petition for reconsideration is denied, you can file a petition for review with a state appeals court. This is a critical juncture because an appeals court will only consider legal issues, not the facts of the case. The appeals court will review the case and determine whether the decision was legally proper.
Step 5: Appeal to the California Supreme Court
If the petition for review is also denied, the last resort is to file an appeal with the California Supreme Court. However, this is a difficult step as the state supreme court only takes a small percentage of cases each year. The court will only consider cases that raise new and important legal issues impacting many state workers' compensation cases.
Workers' Compensation Lawyers Rapid City, SD
At Beardsley, Jensen & Lee, we specialize in helping injured workers navigate this process. Contact us today at (605) 777-7466 to learn how we can support you in your workers' compensation appeals journey.
