Table Of Contents
Workers Comp Appeals Timeline
The workers’ compensation appeals process encompasses several stages, which can extend from a few weeks to several months or more.
Filing an Application for Adjudication
If your claim was denied or, you were unable to reach a settlement with your workers’ compensation claims administrator, you have one year from the date of the injury, the date medical treatment stopped or the last day you received workers’ compensation benefits to file an application for adjudication with the Workers’ Compensation Appeals Board (WCAB).
Upon filing, your employer has 10 days to submit an answer. Subsequently, both parties must file a Declaration of Readiness to proceed to a hearing, provided settlement attempts have been exhausted.
Within 30 days of filing the declarations, a mandatory settlement conference is convened, where a judge may issue a ruling or approve a settlement.
In cases where the settlement conference is inconclusive, a contested hearing is scheduled within 75 days of the Declaration of Readiness filing. The judge renders a decision within 30 days following the hearing’s conclusion.
Appealing the Decision
If dissatisfied with the judge’s decision, you must file a Petition for Reconsideration within 20 days of receipt. This petition must outline your reasons for appeal, cite the issues contested, and present any new evidence unearthed post-original claim filing.
The WCAB reviews your appeal within 60 days. Failure to act within this period results in an implicit denial of your petition.
If your petition is accepted, the board decides on accepting, rejecting, or amending the initial decision. Presentation of new evidence often warrants a review hearing, with the subsequent decision communicated via mail.
This stage of the process may elongate the appeal process by an additional month.
Seeking a Writ of Review
Should disagreement persist, you may request a writ of review from the state appellate court within 45 days of the decision. However, this avenue mainly evaluates the reasonableness of the appeals board’s decision based on claim facts, with overturns being rare.
Appeal to the Supreme Court
Finally, you can lodge an appeal with the California Supreme Court, though this route is seldom pursued in workers’ compensation cases. Even if accepted, the process may entail months before courtroom proceedings commence.
Is There Anything I Can Do to Speed Up a Workers Compensation Claim?
According to Just Work Comp Law, navigating the workers’ compensation process can be arduous, with insurers often prolonging cases to avoid rightful payouts. However, implementing certain strategies can expedite your claim’s progress [1]. Here’s how to streamline your workers’ comp claim:
Keep Detailed Records of Your Injury: One of the most common causes of delays is poorly filed reports. Insurers can use any missing information in your original claim to stall and try to hold out on paying you what you are owed. To reduce the number of hold ups with your case, make sure to record as much as possible about your injury. Write down when and where it occurred, and get written testimonies from anyone who may have witnessed the injury.
Stay Connected with Your Lawyer: Effective communication with your attorney is crucial. Keep them updated on any case developments, such as doctor-recommended time off or medical bills, to facilitate accurate benefit calculations and strengthen your case.
Adhere to Doctor’s Orders: Following your doctor’s instructions is paramount. Failure to comply could jeopardize your claim and provide insurers with grounds to contest payments or settlements.
Heed Attorney Advice: Trust your attorney’s guidance, as they have your best interests in mind. Simple directives, like refraining from social media activity and maintaining honesty with medical professionals, can significantly impact your case.
Clarify Your Objectives: Clearly communicate your goals to your attorney. Whether aiming for a swift resolution or pursuing maximum compensation, ensure your legal representation aligns with your objectives.
Maintain Open Communication with Your Employer: Promptly report injuries to your employer and ensure accurate documentation. If encountering issues, involve your attorney to safeguard your rights and prevent payment disruptions.
By adhering to these steps and collaborating closely with your attorney, you can navigate the workers’ compensation process more effectively and secure the compensation you deserve.
Also Read: Can You Work While on Workers Compensation?
Workers Comp Statistics
- OSHA Impact on Worker Safety: Since its establishment, OSHA has significantly reduced worker injuries and illnesses, with incidents declining from 10.9 per 100 workers in 1972 to 2.8 per 100 in 2019.
- Workplace Fatalities and Injuries (2020): In 2020, 4,821 workers lost their lives on the job, while 2.7 million others suffered nonfatal injuries and illnesses.
- Most Dangerous Industries (2020): Overexertion: 29%; Slips, Trips, and Falls: 23%; Struck or Colliding with Objects: 14%; Motor Vehicle Accidents: 5%
- Common Injuries in Claims: Strains/Sprains: 38%; Fractures: 13%; Contusions: 8%; Inflammation: 7%; Dislocations: 7%; Cuts or Puncture Wounds: 5%
- Impact of First-Year Injuries: First-year injuries resulted in over 6 million days away from work, representing 37% of missed workdays.
- Total Cost of Work Injuries (2020): The total cost of work injuries in 2020 amounted to $163.9 billion.
- Costliest Injuries: Amputation: $102,500; Dislocation: $97,100 Electric Shock: $55,200; Crushing: $54,600; Multiple Trauma: $50,000
- States with Highest Premiums (2019): Wyoming: $1.98 per $100; Alaska: $1.95 per $100; Montana: $1.77 per $100; Hawaii: $1.70 per $100; California: $1.67 per $100; Idaho: $1.60 per $100
- Employer Spending on Workers’ Compensation (2021): In 2021, employer spending on workers’ compensation accounted for 1.2% of total employer compensation costs.
Related Articles:
- 5 Types of Workers Comp Adjuster Tricks
- How Long Do Workers’ Comp Settlements Take?
- What to Do After an Injury at Work?
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If you or a loved one was involved with these matters, you should contact our law firm immediately for a free case evaluation. You may be entitled to a settlement by filing a suit and we can help.
References:
1. https://davis-sanchez.com/can-you-speed-up-a-workers-comp-claim-yes-and-no/