What is the Workers' Compensation Appeals Board  (WCAB) and how does it work?

Workers' Compensation Appeals Board

- What is WCAB and how does it work?

Workers Compensation Law specifies how you should be compensated if you sustain work-related injuries. The Workers' Compensation Appeals Board ensures that Workers Compensation Law is applied accordingly. The WCAB helps whenever you feel the law has not been applied in a just manner. So, it's important that you know more about the WCAB.

Introduction

The Workers Compensation Appeals Board is the body that reviews cases associated with US workers' compensation laws and regulations. The board's main function is to enforce the regulations of the Workers Compensation Law. WCAB first came into existence in 1946. Since then, it continues to carry out its work up to date. It makes final decisions in determining the liability regarding the death or disability of employees. The decision of the Compensation Appeals Board is final. In fact, there is no further judicial or administrative appeal of its decision.

Structure of the Workers' Compensation Appeals Board

The Workers' Compensation Appeals Board (WCAB) consists of Three Members, also sometimes referred to as Commissioners. The United States Secretary of Labor is the appointing authority that appoints the three members of Workers' Compensation Appeals Board. One of the members, by statute, is designated as the administrative manager and Chairman of the Board. The WCAB Commissioners are not just any individuals. They should be attorneys with law licensing in US.

It's worth noting that the structure of the WCAB may vary from state to state. However, it performs its duties through the use of the Labor Code. What may differ is the number of commissioners of the board and the appointing authority.

In the State of California for example, the WCAB consists of seven members. The members are also known as Commissioners. Governor is the appointing authority, and appoints all the seven Commissioners. The Commissioners, by statute, serve a term of office, which lasts for six years. At least 5 out of the 7 Commissioners must be judges with current law licensing in California.

Functions of the WCAB

The WCAB has judicial powers that the Labor Code has vested on it. The board has the responsibility to exercise its judicial powers in a sound and reasonable manner. It uses its judicial powers to provide leadership and guidance. It provides leadership to the community that implements the Workers Compensation Law. WCAB does this through regulations and case opinions.

The WCAB has many functions. The major one is to review petitions. It does this for any chance of reconsideration of the decisions by the judges of workers' compensation administrative law of the Division of Workers' Compensation. Another major function of the WCAB is to regulate the adjudication process. The board performs this function by coming with rules of procedure and practice. It also adapts these rules and practices.

How the Workers Compensation Appeals Board works

Workers compensation insurance company and the injured worker's claims adjuster may have some disputed issues. They may not be able to resolve informally. In such a case, a formal hearing may be set with a WCJ or Workers Compensation Judge. The WJC will then review evidence at a trial. It will also review witness testimony, and medical report.

After which, it will issue a decision that will formally resolve the disputed issue. Examples of the disputed issues in the workers compensation claim are:

  • Authorization for medical treatment
  • Level of a permanent disability
  • Disagreements over the injured workers weekly disability rate
  • Denial of the claim completely by the claims adjuster


One or both parties may not be satisfied with the decision of the WCJ. In such a case, they can appeal the decision to the WCAB. Either party can make the appeal in form of a Petition for Reconsideration. You are required to file the appeal with the Commissioners at the WCAB.

After filling the proper forms, the Workers Compensation Appeals Board will review the petition. The board will review both the petition itself and the decision of the WCJ. Typically, the WCAB usually assigns a three-member panel of commissioners to do the review. Each of the three Commissioners will review the case. Commissioner will make a decision before the team passes the file to the WCAB staff for execution. It's worth noting that this decision is usually final.

The panel, depending on its findings, may completely dismiss the Petition for Reconsideration. This may be done due to various reasons. Alternatively, the panel may outright deny the request. In this case, it will affirm the decision of the Workers Compensation Judge. They may also deny the request by giving their own opinion rather than affirming the WCJ's decision. Alternatively, the panel may decide to return the case back to the Workers Compensation Judge. The JCJ will then have to review the case.

Guidelines for filing a petition for reconsideration and within which the WCAB should act

If the final decision of the WCJ doesn't satisfy you, then you can petition for reconsideration. You should appeal the decision within twenty days after the WCJ services you with the decision. An adverse party has up to 10 days to file an answer. It's good to know the justifications for reconsideration. This will help you time wasting.

Here are the grounds for reconsideration:

  1. That the workers compensation judge (WCJ) acted beyond its powers
  2. That there is an evidence that may not have been produced or considered at the hearing
  3. That the decision was secured by fraud
  4. That the evidence doesn't justify the decision
  5. That the decision is not supported by the findings of fact

The law specifies the time limit within which the petition is acted upon. By statute, the workers' compensation judge (WCJ) has 15 days from the day the petition to act. WCJ will prepare a recommendation and a report to the WCAB explaining its decision. It will do this in respect to the points the aggrieved party has raised. The WCAB must take action on the petition within 60 days. Otherwise, the petition will be automatically denied by operation of the statute.

Mission of the Workers Compensation Appeals Board (WCAB)

The mission of the WCAB is very clear. It is to hear and decide the cases on petition from the decisions of the OWCP. Well, OWCP is an abbreviation of the Office of Workers' Compensation Programs. The board aims to do its job in an expeditious manner. The WCAB makes its decisions in accordance with the statutory mandate of the board. The board ensures that the OWCP does its work properly. The decisions must be based on the regulations of the Workers Compensation Law.

Any injured federal worker is usually given the opportunity to a full hearing. The Office of Workers' Compensation Programs' Branch of Hearing and Reviews hears the cases. After this hearing and review, the WCAB reviews the record. The board then makes a decision. The WCAB ensures that there is no violation of the interests and rights of injured workers. On the same note, the board also ensures that the judgment is fair and just to employers.

Conclusion

WCAB is simply the body or agency that implements the US Workers' Compensation Act. The board enforces the Workers Compensation Law. This law states that an employer should pay an injured employee's job-related disability and medical benefits. It also states the benefits are paid to the dependants in case an employee dies.

ClaimFight.com - Sherlin Lindsay - author / writer

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