Santa Rosa Workers' Compensation Appeal Lawyer
Our Firm is Ready to Appeal Your Denied Claim on Your Behalf
At Pacific Workers', we understand that a denied claim can be disheartening, but it doesn't have to be the end of your workers' compensation case. We specialize in the appeals process and are committed to fighting for your rights.
Our legal team boasts a rich history of successfully representing injured workers throughout California, including Santa Rosa. With years of experience, we have a profound understanding of the nuances of the state's workers' compensation system. We are well-versed in the intricacies of appeals and have a proven track record of securing favorable outcomes for our clients.
Call (888) 740-6434 or fill out our online contact form today to request a free consultation.
Understanding the Appeals Process
The workers' compensation appeals process in California provides a mechanism for injured workers or their employers to challenge decisions made by the state's Division of Workers' Compensation (DWC) regarding workers' compensation benefits. It is designed to ensure that injured workers receive the appropriate compensation and medical care for work-related injuries or illnesses.
Here's an overview of the workers' compensation appeals process in California:
- Filing a Workers' Compensation Claim: The process typically begins when an employee sustains a work-related injury or illness and notifies their employer. The employer is required to provide the injured worker with a workers' compensation claim form (DWC-1) to initiate the claims process.
- Employer's Role: The employer must report the injury or illness to their workers' compensation insurance carrier and file a report with the DWC.
- Medical Treatment and Benefits: Injured workers are entitled to receive medical treatment and temporary disability benefits if they are unable to work due to their injury or illness.
- Claims Administrator Review: The workers' compensation insurance carrier will review the claim and make a determination regarding benefits. If the claim is accepted, the injured worker receives benefits and medical treatment. If the claim is denied, the injured worker has the right to appeal.
- Filing an Appeal: If a claim is denied, the injured worker can file an Application for Adjudication of Claim with the DWC to formally initiate the appeals process. The DWC will assign a case number and schedule an initial hearing before a workers' compensation administrative law judge (WCJ).
- Mandatory Settlement Conference (MSC): Before a formal trial, a mandatory settlement conference is held to encourage parties to reach a resolution. If a settlement is reached, it is documented and becomes binding.
- Formal Trial: If the parties cannot reach a settlement, the case proceeds to a formal trial before a WCJ. Both sides present evidence, witnesses, and arguments to support their positions. The WCJ issues a written decision, known as a Findings and Award.
- Appealing a WCJ's Decision: Either party (the injured worker or the employer/insurance carrier) can appeal the WCJ's decision to the Workers' Compensation Appeals Board (WCAB). The appeal must be filed within a specified timeframe.
- WCAB Review: The WCAB reviews the case, considering the evidence presented at the trial. The WCAB may issue a decision affirming, modifying, or reversing the WCJ's decision.
- Further Appeals: If either party is dissatisfied with the WCAB's decision, they can seek further review by filing a petition for a writ of review with the California Court of Appeal.
- Final Resolution: The appeals process can continue through higher courts if necessary. Once all appeals are exhausted or if parties reach a settlement agreement at any stage, the case is resolved.
Why Choose Us For Your Appeal?
We have an experienced team of attorneys who have earned a reputation for success in the realm of workers' compensation appeals. Our attorneys understand the complexity of workers’ compensation laws and regulations, as well as how these rules apply to specific circumstances. This expertise enables us to build powerful appeal cases designed to reverse initial denials.
Here are several ways we can help you:
- Maximizing Your Benefits: We have a track record of securing higher compensation packages for our clients compared to those who choose to represent themselves.
- Fighting Insurance Companies: Insurance companies are notorious for trying to minimize payouts. Our attorneys are skilled at negotiating with insurance companies to ensure you receive fair compensation.
- Peace of Mind: Having an experienced lawyer by your side provides peace of mind during a stressful time. You can focus on your recovery while we handle the legal complexities.
We believe that every worker deserves fair treatment and adequate compensation for their injuries. If you've been denied, don't lose hope – let our experienced Oakland-based attorneys help you navigate through this complicated process.
Don't let a denied claim prevent you from getting the benefits you deserve! Contact us today at (888) 740-6434 – let's get started on your appeal!
We have Helped OVER 8,000 CLIENTS aND WE CAN HELP YOU TOO!
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Thank you for being so kind and completely sympathetic to my case!
“I started my fight against my company's workers comp and after talking to Almarie for the first time I already felt a lot of weight off my shoulders. It feels nice to have someone fighting for your rights but also keeping you in check for your own good.”
Jazzie D. Daly City, CA -
They took care of me!
“Bilal worked on my case and he was very professional, friendly, and kind to me. I was so nervous about my deposition and he made me feel very comfortable and less stressed about the whole situation.”
Gabi O. Sacramento, CA -
The most down to earth team I have ever met!
“They have strong communication and I was respected throughout the whole process. They had never given up on me!”
Nekealla C. Tracy, CA -
I'm forever grateful & thankful to all!
“I especially want to thank Mr. Jason Insdorf, who worked in attaining a settlement I never expected.”
L.S. Union City, CA
Workers' Comp FAQ
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Am I Eligible for Workers’ Compensation?
In California, all employees are eligible for workers’ compensation with very few exceptions. If you are classified as an “employee” (rather than an “independent contractor”), you are eligible to receive benefits. This is true regardless of how many employees your employer has, how many hours you work, how much you make, whether you work part-time or full-time, or whether you are a seasonal worker. Additionally, undocumented workers are also eligible for workers’ compensation granted they meet all other eligibility requirements. In contrast, independent contractors and certain other workers, including some volunteers, household workers who are employed by a family member, and others, are not able to file for workers’ compensation benefits.
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Can't I Just File for Workers' Compensation on My Own?
Filing for workers' compensation on your own increases the chances that your claim will be denied. One small misstep can prevent you from obtaining the compensation you need for your injuries. In addition, the process is usually complex and tedious, especially for someone with no workers' compensation law experience. It is extremely advantageous that you seek reliable and experienced legal guidance for your claim.
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What Can I Expect from the Workers' Compensation Process?
As soon as you reach out to us for help, we will assign you a full-time case manager and attorney. An application will be filed with the Workers' Compensation Appeals Board (WCAB) on your behalf. We will get started on your case immediately to help you receive the medical care you need. If we are unable to receive a fair settlement from the insurance company, we are ready and willing to take your case to trial. After a few months, you will most likely give a deposition. One of our highly experienced attorneys will prepare you and stand at your side the entire time. You don't even have to attend court hearings! One of our trained hearing officers or attorneys can attend on your behalf.
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Can My Employer Tell Me to Use Sick Time or Vacation/Personal Time off (PTO) If I’m Injured at Work?
Following a work-related injury, you may not receive workers’ compensation benefits right away or your workers’ compensation claim may be denied. You may receive a note from your doctor that you may take time off work due to your injuries, but how will you be paid if you are not actively seeking workers’ compensation benefits? Your employer may tell you to use your state-mandated/employer-provided sick time in order to continue being paid while you are out of work. Once this sick time is exhausted, your employer may tell you that the only way you can continue to be paid is if you use your vacation or PTO time. In some cases, this may actually be the only way to continue receiving wages while you are out of work and not receiving workers’ compensation benefits. For more information, check out our video with Attorney Bilal Kassem on this topic by visiting our Facebook page!
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Can I Get Workers’ Compensation If I Was Fired?
If you were terminated while already receiving workers’ compensation benefits, this does not necessarily affect your right to receive benefits. However, if you were terminated “for cause” (for example, if you were fired because you were caught stealing from your employer), you will not be able to continue collecting benefits. If you were not fired for cause, but were laid off due to your position being terminated or various other reasons, you may still be able to continue collecting your workers’ compensation benefits. If you believe you were terminated because you filed for workers’ compensation or because you were hurt at work, you may have grounds for a retaliation claim. Learn more, including whether you can continue receiving workers’ compensation benefits if you were laid off due to the coronavirus pandemic, see our video with Attorney Bilal Kassem on our Facebook page.
