Workers’ Compensation Appeals Board

[This blog has been updated on September 30, 2019 with additional information about the Workers’ Compensation Appeals Board.]

Workers’ Compensation Appeals Board explained by santa rosa workers compensation lawyer

The Workers’ Compensation Appeals Board is a judicial body with the power to review petitions for reconsideration of workers’ compensation administrative law judge decisions. The Workers’ Compensation Appeals Board is also responsible for regulating the adjudication process through the adoption of rules of procedure and practice.

Workers’ compensation lawyers practice law before the California Workers’ Compensation Appeals Board. These attorneys represent injured workers in their pursuit of a variety of benefits that may be available to them for work injuries, including compensation for time off work while recovering from an injury, payment of medical bills, and many other benefits.

The Workers’ Compensation Appeals Board

The Workers’ Compensation Appeals Board, a seven-member, judicial body appointed by the Governor and confirmed by the Senate, exercises all judicial powers vested in it by the Labor Code. Its major functions include review of petitions for reconsideration of decisions by workers’ compensation Administrative law judges and regulation of the adjudication process by adopting rules of practice and procedure.

Each state has its own rules and regulations regarding workers’ compensation matters, so the California Workers’ Compensation Appeals Board handles California matters. Other states have similar judicial bodies that handle administrative appeals, such as workers’ compensation cases.

What is a Petition for Reconsideration?

When an injured worker and the workers’ compensation insurance company’s claims adjuster have disputed issues which they cannot resolve informally, a formal hearing can be set with a Workers’ Compensation Judge (WCJ). There are many examples of disputed issues in a workers’ compensation claim, including denial of the claim outright, disagreements over an injured workers’ weekly disability rate, level of permanent disability, authorization for medical treatment, and many, many others. After reviewing evidence at a trial, including medical reporting and possibly witness testimony, the WCJ will issue a decision formally resolving the issues in dispute. Either party then has the right to appeal the decision made by the WCJ. The appeal is made in the form of a Petition for Reconsideration and filed with the Commissioners at the Workers’ Compensation Appeals Board

Petition for Reconsideration of Decision by Workers’ Compensation Judges

It’s best to consult with an attorney if there are disputed issues with a workers’ compensation claims adjuster, and certainly before taking your case before a WCJ.  While it is possible to file an appeal of a decision of a WCJ and file a Petition for Reconsideration on your own, the filings are regulated with strict time frames and it’s important to make sure that you have all of your documentation ready on time. You can download a Petition for Reconsideration online from the DIR (https://www.dir.ca.gov/wcab/about_wcabp.htm).  Petitions must be filed with the office of the Appeals Board in San Francisco.

free workers compensation claims checklist

Three Member Panel Review

Once the proper forms are filed, a three-member panel of Commissioners will be assigned to review the Petition for Reconsideration and the decision of the WCJ. Each Commissioner reviews the case, makes a decision, and then the file is passed to the Appeals Board staff for execution of a written order. The panel may outright dismiss a Petition for Reconsideration for any number of reasons. Alternatively, they may deny the request by affirming the decision of the WCJ, or they may deny it while rendering their own opinion of the case. The panel could also grant the request for reconsideration and return the case to the WCJ for further review.

In order to protect your rights, as soon as you become aware of a dispute with a claims adjuster, you should reach out to a workers’ compensation attorney. Remember, the insurance company has attorneys fighting for them. Why shouldn’t you?

California Workers’ Compensation Decisions

There are a few different types of decisions made by the Appeals Board. The first of these is an en banc decision. This term refers to a matter that has been reassigned by the chairman of the board after a majority vote of the commissioners in certain cases involving novel issues, or just to achieve a uniform decision.

Another type of decision is called a significant panel decision, which involves cases that are identified by the WCAB as cases that involve new issues or address recurring issues of importance. These decisions are reviewed by each commissioner, and all commissioners have agreed that the decision is one that merits general dissemination.

There are also cases which are pending an appellate review by California District courts. These cases are included on a list of workers’ compensation cases where there have been writs of review granted by the district courts of appeal as well as the state Supreme Court. The list is updated regularly each month. The clerk of the court where the writ of review is pending can give out further information regarding the setting of oral arguments or the status of a case.

If you have questions about your rights under workers’ comp call our firm. An injured worker in Northern California can contact Kneisler & Schondel to learn more about their rights and how a workers’ compensation lawyer can help them. Call us at (707) 542-5132 or fill out our online contact form to learn how we can help.