San Diego Workers’ Compensation Appeals Lawyer

You suffered an injury at work, and the workers’ compensation insurer denied your claim. You contested the denial at a hearing before the local workers’ compensation office, and the judge sided with the insurance company. You might not know what to do next.

Your benefits are worth fighting for, so do not give up. Contact a San Diego Workers’ Compensation appeals lawyer for help pursuing your rights. An appeal is a complicated legal maneuver and not something to handle without professional representation. Seek guidance from a reliable attorney in the area.

Request a Hearing with Workers’ Compensation Appeals Board

If an insurance company denies someone’s workers’ compensation claim, the claimant could request a hearing before a judge at their local Workers’ Compensation Appeals Board (WCAB). If the claimant disagrees with the decision after a hearing, the claimant could file a petition asking the WCAB to reconsider the decision.

According to California Labor Code §5903, a claimant must file the petition within 25 days of the judge’s order if the order was mailed to the claimant’s home. There are only five grounds that could support a petition to reconsider:

  • The evidence does not support the findings of fact
  • The factual findings do not support the decision
  • The judge acted outside the scope of their power
  • The order or decision resulted from fraud
  • The claimant has new evidence that they could not have presented at the earlier hearing

The claimant must present a detailed analysis of the basis for their request for reconsideration. A San Diego workers’ compensation attorney could prepare the appeal petition. The WCAB has 60 days to decide whether to act on the petition. If the WCAB accepts the petition, it will reconsider based on the record before it, unless new information is the grounds for reconsideration. In that case, the WCAB might hold another hearing to receive testimony about the new information.

Request to State Court for Writ of Review

If dissatisfied with the WCAB’s decision on reconsideration, a San Diego claimant and their local attorney could request the California Fourth District Court of Appeals to consider the matter and issue a writ of review. The claimant must file the request within 45 days of the WCAB decision regarding the request for reconsideration.

The Appellate Court may not consider new evidence or substitute its judgment for that of the WCAB. Instead, the Court could review the record of the WCAB proceedings to determine whether the result was reasonable given the information available to it at the time of the hearing. It is possible, but unusual, for the Court to find that the record could not reasonably support the WCAB decision.

If the Appellate Court does not find in favor of the claimant, the only remaining avenue for relief is a request that the California Supreme Court hear the matter. However, claimants should understand the Court only hears cases that present novel issues of law. It is rare for the Court to consider a Workers’ Compensation case.

Call a San Diego Workers’ Compensation Appeals Attorney Today

If you suffered a work injury, you are legally entitled to appropriate compensation under the workers’ compensation program. If your employer’s insurance company is denying you your benefits, you have multiple legal options available to you.

A San Diego workers’ compensation appeals lawyer could be helpful in guiding you through the complicated legal process. Call today to talk over your case with a knowledgeable professional on our team.