Workers’ compensation insurance providers often disagree with injured and sick workers about what benefits should be provide to them. Fortunately, if your employer’s insurance company denied your workers’ compensation claim, or you are not receiving sufficient benefits to meet your needs, you can request that a judge reconsider the decision.
Unfortunately, filing an appeal for a workers’ compensation claim is not a simple process, especially if you try to proceed without assistance from a seasoned workers’ compensation attorney. When you want to fight effectively for your workers’ compensation rights, you will need a capable Torrance workers’ compensation appeals lawyer by your side.
Individuals who want to appeal an insurance company’s decision regarding their workers’ compensation claim can begin the appeals process by completing an “Application for Adjudication of Claim” form and submitting it to their county’s Division of Workers’ Compensation (DWC) office. One would need to complete this process within five years of their original injury or illness.
The DWC can request additional information and documentation from the injured individual before accepting this application. However, it is important to note that the DWC does not handle appeals or denials and is only where the paperwork is submitted.
If that decision is in the injured person’s favor, the DWC will assign them a case number. At that point, the individual must:
There are multiple ways of approaching this portion of the appeals process, and a Torrance workers’ compensation attorney can provide further information and offer individualized, tactical guidance.
At the scheduled hearing, the injured person and their claims administrator will negotiate a settlement agreement. If the parties cannot reach an agreement, the case will proceed to trial.
At trial, both sides can present witnesses and documentary evidence in support of their position. The trial judge—who will be a different person from the judge who presided over the previous hearing—will make a decision within 30 to 90 days and notify the involved parties about it by mail.
If the injured party disagrees with the trial judge’s decision, they may submit a Petition for Reconsideration form to the state Workers’ Compensation Appeals Board (WCAB) no later than 20 days after receiving notice of the judge’s verdict. If the WCAB’s decision is also unfavorable, a workers’ compensation appeals attorney in Torrance can help progress the appeal to the California Court of Appeal and, potentially after that, to the California Supreme Court.
A successful appeal will generally not result in you receiving extra benefits. Instead, it ensures that you receive the ones you were entitled to based on your specific injury or illness. Getting exactly what you deserve could be vital to protecting your best interests after getting seriously hurt or sick on the job, particularly if your condition will prohibit you from working long-term.
A Torrance workers’ compensation appeals attorney can discuss your case and develop a strategy for you. Call us today to schedule a confidential consultation.
