Preparing for the Workers’ Compensation Appeals Process in California
If you’ve been injured at work, you likely assumed that getting the benefits you deserve would be easy. That’s the point of the workers’ compensation system; in exchange for giving up your right to file a personal injury claim, you receive certain guaranteed benefits when you are injured at work. Unfortunately, Southern California employers don’t always make it very easy. Whether they simply want to keep their accident numbers down, believe that the claim is fraudulent, or are following the guidance of their insurance company, they may deny legitimate claims. That’s where we come in. At Pisegna & Zimmerman, we fight on behalf of injured workers throughout the region. We go one step further to make this process as easy as possible for you. By hosting meetings over Zoom and managing your documents over DocuSign, you never even have to leave home. Call us at 818-888-8888 to set up a consultation with our team right away.
In California, workers’ compensation appeals cases are overseen by the Workers’ Compensation Appeals Board, or WCAB. This is a seven-person board that is appointed by the governor. They issue decisions regarding workers’ compensation appeals, utilizing an in-depth understanding of workers’ comp law. They are bound by set rules and procedures that govern how they work and how they make their decisions.
When is an Appeal Necessary?
There are a number of situations resulting in claim denial. In these situations, you have the freedom to request an appeal and pursue the benefits you are owed. For example, your employer may claim that the injury did not happen while you were on the clock and therefore does not warrant compensation. They may also claim that you did not report the injury in time and that your right to file a claim has expired. If the evidence for your claim conflicts with your version of events or what eyewitnesses have claimed, the insurance company may deny your claim because they believe it’s fraudulent.
You do not have to accept this decision. You can file an appeal and allow your case to be reviewed by the WCAB.
The Appeals Process in California
This process begins with one of two forms: a Petition for Reconsideration or a Petition for Removal. A Petition for Reconsideration requests that the WCAB review the decision made by the insurance company or claims administrator. The board will look over all of the evidence and make a decision based on that. You may file a Petition for Removal if you don’t want the case to be managed by the insurance carrier. In this situation, the case is heard by an administrative law judge. You have to move fairly quickly if you go this route, as you only have 20 days after your claim has been denied. The administrative law judge will look into the evidence you provide and determine whether or not your case should have been denied.
In either case, you attend the hearing. Both sides get a chance to present their side, so it is often helpful to have a workers’ compensation attorney with you if you are afraid of being rattled or intimidated by your employer or their insurance representative. Depending on how the hearing goes, they will either grant or deny your request.
If your request is denied, you may then file a Writ of Review to exercise your final chance at an appeal.
Strategies for a Successful Appeal
Pursuing a workers’ compensation appeal can feel overwhelming—you’ve already presented your evidence and it wasn’t enough, which may make you feel like it’s pointless to continue on. However, remember that the insurance company has a vested interest in denying your claim. It limits the amount they have to pay out. By taking the issue to a neutral third party that only oversees workers’ compensation cases, you have a better shot at having your case judged by its merits.
First, make sure you know why your claim was denied. If your claim was denied because the evidence conflicts with eyewitness testimonies, providing more eyewitness testimonies is likely not the best strategy. However, if your claim was denied because they couldn’t find any witnesses and you know someone who saw your accident, that could be useful information.
This is an area where you truly need a workers’ compensation attorney. Almost every employee is entitled to workers’ compensation benefits after a workplace injury, and if your claim has been wrongfully denied, a workers’ comp lawyer can help protect your rights.
Fight for Fair Compensation With Pisegna & Zimmerman
The sooner you connect with the team of workers’ comp lawyers at Pisegna & Zimmerman, the sooner we can begin advocating for you and learning more about your claim. We can meet over Zoom and handle your documents remotely via DocuSign, limiting your obligations during this stressful time. Just contact us online or call us at 818-888-8888.

William Zimmerman is an experienced Los Angeles work injury attorney at Pisegna & Zimmerman. He offers invaluable advice and assistance when dealing with the often complicated workers’ compensation system. As part of Pisgena & Zimmerman, he and his team are a full-service law firm that is dedicated to obtaining the maximum amount of compensation from all available sources.