Appealing a Neck Injury Claim at Work

 Posted on January 31, 2024 in Denied Claims and Appeals

You may have the right to appeal if you suffered a neck injury at work and had your workers’ compensation claim denied. The appeals process can seem daunting, but understanding the steps involved can help you effectively argue your case. A California workers’ compensation attorney can also help figure out the potential of your claim.

How Neck Injury Claims Are Evaluated

When you file a neck injury claim in California, the Workers’ Compensation Appeals Board (WCAB) analyzes your claim based on various factors. They determine if the injury occurred within the scope of employment and if enough credible medical evidence supports an injury serious enough to warrant compensation and treatment.

If the WCAB denies your claim due to lack of evidence or because they feel the injury falls outside work duties, you can challenge the decision through an appeal. As you prepare your appeal application, keep these evaluation criteria in mind.

The Appeals Process and Timeline

The appeals process involves procedural deadlines you must follow to have your appeal evaluated. The first step falls on you as the applicant - you must file a Declaration of Readiness to Proceed form with the WCAB within one year from the date of injury. This form states you have completed treatment evidence-gathering and are ready to begin formal hearings.

Next, you must file your Petition for Reconsideration within 20 days of receiving notice the WCAB denied your original neck injury claim. This written petition outlines why you feel the original decision falls in error and formally requests reevaluation from the WCAB.

The WCAB then has 60 days to act upon your appeal petition. Their three options are:

• Grant your petition and reverse the original decision.
• Deny your petition, upholding their original ruling.
• Fail to act within 60 days, in which case the original decision automatically reverses by default.

Building Your Appeal Case

As you draft your Petition for Reconsideration, your case should include credible evidence. Useful evidence includes:

• Medical Records: Supply records documenting the nature of your neck injury and extended treatment. Records should come from the initial injury through current-day treatment.
• Medical Opinions: Submit written medical opinions from your doctor detailing how your work duties directly caused or aggravated your neck injury. Supporting opinions from specialists carry significant weight.
• Witness Statements: Written accounts from colleagues who witnessed the accident or can attest to your work duties leading to injury prove useful.

While you do not have to submit new evidence, timely documentation properly supporting the work-relatedness of your injury strengthens your petition.

Contact a Morgan Hill, CA Workers’ Compensation Lawyer

Rushing through your petition fails to demonstrate the full grounds as to why the WCAB should reverse its ruling. Set aside ample time to undergo the appeals process with a Gilroy, CA workers’ compensation attorney to ensure you have the necessary paperwork and evidence. Call Cramer + Martinez at 408-848-1113 for a free consultation.