She Paid Into the System for 38 Years — Then Her Workers’ Comp Claim Was Denied

Roughly 1 in 10 workers’ compensation claims filed in California is disputed or denied at the initial stage, according to estimates from the California Department…

She Paid Into the System for 38 Years — Then Her Workers' Comp Claim Was Denied
She Paid Into the System for 38 Years — Then Her Workers' Comp Claim Was Denied

Roughly 1 in 10 workers’ compensation claims filed in California is disputed or denied at the initial stage, according to estimates from the California Department of Industrial Relations. For the workers behind those numbers — people who showed up every day, paid into the system, and got hurt doing their jobs — a denial doesn’t feel like a data point. It feels like the floor dropping out.

I first heard about Rosalind Bianchi through Father Marcus Delgado, the pastor of a small parish in Sacramento’s Oak Park neighborhood. He mentioned her in passing during a community meeting I attended while reporting on how working families were navigating rising costs and stalled federal relief programs. “She’s not someone who asks for help,” he told me. “That’s what makes her situation so hard to watch.”

A few weeks later, I drove to Rosalind’s home in Sacramento’s Pocket District on a gray Tuesday in January 2026. She opened the door in jeans and a flannel shirt, her right arm still in a soft brace. She was 67 years old and had worked as a licensed union electrician for nearly four decades. She didn’t look like someone who was struggling — but that, I would learn, was entirely the point.

The Fall That Started Everything

The injury happened on March 14, 2025. Rosalind was working a commercial retrofit job at a warehouse in West Sacramento when she stepped off a scaffolding platform and her foot caught a loose bracket. She fell approximately six feet, landing hard on her right shoulder and lower back. She was transported by ambulance to UC Davis Medical Center, where imaging confirmed a torn rotator cuff and two herniated discs in her lumbar spine.

“I’ve been doing this job since I was 29,” Rosalind told me, sitting at her kitchen table with a mug of tea she barely touched. “I’ve seen guys get hurt. I always thought if it happened to me, the system would just… work. That you’d file, and they’d take care of it.”

Her employer’s insurance carrier acknowledged the claim in April 2025. Then, in June, a letter arrived denying the claim on the grounds that Rosalind had a “pre-existing degenerative spinal condition” documented in a 2019 routine physical. The insurer argued her injuries were not solely work-related and therefore not fully compensable under California law.

KEY TAKEAWAY
In California, insurers can deny a workers’ comp claim by arguing that a pre-existing condition — not the workplace incident — was the primary cause of injury. Workers have the right to appeal through the Workers’ Compensation Appeals Board (WCAB), but proceedings routinely take 12 to 24 months or longer before a hearing is scheduled.

Rosalind filed a formal appeal with the California Workers’ Compensation Appeals Board in August 2025. As of April 2026, that appeal remains pending. In the meantime, she has not received a single dollar in workers’ compensation benefits — no temporary disability payments, no reimbursement for the $14,200 in out-of-pocket surgical costs already accrued.

When the Income Stops — But the Mortgage Does Not

Rosalind and her husband, David, purchased their home in the Pocket District in late 2021 for $618,000. At the time, she was earning roughly $94,000 a year in union wages plus overtime, and the couple stretched to make it work. Their mortgage payment came to $4,100 per month — aggressive, but manageable on a union electrician’s salary.

$94,000
Rosalind’s annual union wage before injury

$0
Workers’ comp received after denial

$4,100
Monthly mortgage obligation

David has been a stay-at-home parent since their youngest child was born. Their three children are now adults, but David, who stepped out of the workforce in 2009, has not re-entered it. The couple’s financial architecture was built entirely around Rosalind’s salary. When that salary stopped, there was no secondary income to absorb the shock.

Through her union — IBEW Local 340 — Rosalind received short-term disability benefits beginning in May 2025. Those payments came to $1,860 per month, just under half of her regular take-home pay. It slowed the bleed, but it didn’t stop it.

“We had about $38,000 in savings when this started. By October we were under $12,000. That’s when I realized this wasn’t a short-term problem. This was a different kind of life.”
— Rosalind Bianchi, 67, union electrician, Sacramento, CA

By late fall of 2025, Rosalind had missed two consecutive mortgage payments. Her lender placed the loan into a 90-day forbearance program — temporarily pausing required payments while she sought a longer-term resolution. That forbearance window closed in February 2026, with the two missed payments added to the back end of her loan balance.

Searching for Relief Across Systems That Don’t Communicate

Rosalind’s situation didn’t fit cleanly into any single relief program. She was 67 — eligible for Social Security retirement benefits, but claiming early would permanently reduce her monthly payment. Her injury, however, opened a separate door: Social Security Disability Insurance. She applied in September 2025.

⚠ IMPORTANT
The average SSDI processing time for an initial application is 3 to 6 months, according to the Social Security Administration. Approximately 67% of initial SSDI applications are denied. If an applicant also has an open workers’ compensation case, SSA may offset SSDI payments once both benefits are approved simultaneously — a calculation that can significantly reduce the net amount received.

Through a referral from Father Delgado’s church network, Rosalind also connected with a nonprofit housing counselor affiliated with the California Housing Finance Agency. That counselor helped her pursue a loan modification — a permanent restructuring of her mortgage terms that would reduce her monthly payment by approximately $620 if approved.

“Nobody tells you how many different places you have to go,” Rosalind told me. “Workers’ comp is one system. SSDI is another. The mortgage is another. And they don’t talk to each other. You’re the one running between all of them, filling out the same paperwork over and over, explaining the same injury to people who are going to make a decision and never meet you.”

Rosalind’s Relief Timeline: March 2025 – April 2026
1
March 2025 — On-the-job fall at West Sacramento warehouse; ambulance transport, surgery confirmed

2
May 2025 — IBEW Local 340 short-term disability payments begin at $1,860/month

3
June 2025 — Workers’ comp claim formally denied; pre-existing condition cited by insurer

4
August – September 2025 — WCAB appeal filed; SSDI application submitted separately

5
November 2025 — Mortgage forbearance approved after two missed payments; housing counselor engaged

6
April 2026 — Loan modification under review; SSDI pending; WCAB preliminary hearing set for May 2026

An Outcome Still Being Written — and What It Has Cost

When I asked Rosalind how she was doing — really doing — she was quiet for a long moment. She set down her mug and looked out the window toward the backyard where a garden she planted years ago had gone mostly to weeds since the injury. Then she answered.

“I’m not angry. I’m just tired. I did everything right — I worked, I paid in, I followed the rules for 38 years. And the rules just… didn’t follow back.”
— Rosalind Bianchi, Sacramento, CA

As of our January 2026 conversation, Rosalind’s savings had been drawn down from $38,000 to approximately $9,400. Her right shoulder still ached in cold weather, and she remained unable to return to the physical demands of electrical work. The legal fees she had accumulated fighting the workers’ comp denial — roughly $6,800 through a workers’ comp attorney working on contingency — would be deducted from any eventual settlement.

There was no tidy resolution to offer. The forbearance bought time. The loan modification, if approved, would reduce her monthly payment to approximately $3,480 — still steep on disability income alone. Her SSDI application remained under SSA review. The WCAB hearing, now scheduled for May 2026, could go any number of ways.

“The best I can say is that the house is still ours,” she told me as I was leaving. “For now. That’s the best I’ve got right now.”

Rosalind’s case isn’t exceptional in its structure — denied claims, over-leveraged mortgages, and bureaucratic systems that require claimants to navigate each one independently are familiar terrain for anyone who has spent time reporting on economic hardship in this country. What made her story worth telling was the quiet clarity of someone who understood exactly what had happened to her and refused to be consumed by it. She was tired, yes. But she was still there: filling out the paperwork, taking the calls, waiting on a system she’d trusted for nearly four decades.

Father Delgado told me she wasn’t someone who asked for help. Sitting across from her that January morning, I understood what he meant. She wasn’t asking for anything from me either. She just wanted someone to hear what it actually felt like when the safety net has a hole in it — and when the person who falls through it has done nothing wrong at all.

Related: He Earned a Raise, Then Took a Fall at Work — How a Denied Workers Comp Claim Unraveled One Man’s Finances

Related: His COBRA Premium Cost More Than His Rent. Then the IRS Held His $3,247 Tax Refund for 44 Days

Frequently Asked Questions

What can you do if your workers’ comp claim is denied in California?

Workers in California can appeal a denial to the Workers’ Compensation Appeals Board (WCAB). The appeal must typically be filed within one year of the denial. The process involves a Declaration of Readiness to Proceed, a mandatory settlement conference, and potentially a trial before a workers’ comp judge. Cases routinely take 12 to 24 months or longer to resolve.
Can you apply for SSDI while a workers’ comp appeal is pending?

Yes. SSDI and workers’ compensation are separate systems, and you can apply for both simultaneously. However, the Social Security Administration may apply an offset to reduce SSDI payments if workers’ comp benefits are also eventually awarded — combined benefits are generally capped at 80% of pre-disability average earnings.
Does a pre-existing condition automatically disqualify a workers’ comp claim in California?

No. Under California law, a pre-existing condition does not automatically bar a claim. If a workplace incident aggravated or combined with a pre-existing condition to produce the current disability, the employer may still be liable for the portion of injury attributable to the work event. This is a frequently litigated area and the basis of many WCAB appeals.
How does mortgage forbearance work, and what happens when it ends?

Mortgage forbearance is a temporary pause or reduction in required payments granted by a lender, typically for 90 to 180 days. When forbearance ends, missed payments are generally added to the back end of the loan or repaid via a repayment plan. It defers the debt — it does not eliminate it. Borrowers should contact their servicer before the window closes to arrange a resolution.
How long does SSDI take to process in 2026?

According to the Social Security Administration, initial SSDI decisions currently take between 3 and 6 months on average, with some offices reporting longer backlogs. Approximately 67% of initial applications are denied. Claimants who are denied can request reconsideration and, if necessary, a hearing before an Administrative Law Judge — extending the total timeline to 18 months or more in many cases.

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Vivienne Marlowe Reyes

Senior Tax & Stimulus Writer covering stimulus payments, tax credits, and IRS policy. M.S. Tax Policy Georgetown. Former U.S. Treasury analyst. Enrolled Agent.

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