Workers’ compensation law is complex and ambiguous. Many clients do not understand where to begin with filing a workers’ compensation claim. It is important to learn about some of the most fundamental aspects of workers’ compensation cases before you seek out a personal injury lawyer in Alhambra.
General Information Regarding Workers’ Compensation
You may have suffered injuries at the workplace, and workers’ compensation is a program that permits you to receive benefits. Typically, workers’ compensation provides coverage for lost earnings, rehabilitation costs, and medical expenses. It is necessary that you report any workplace injury immediately so you can seek workers’ compensation benefits.
You should inform your manager of the injury as soon as it occurs. Your employer should make a report that documents the details regarding the accident. Also, you should obtain copies of the records your employer creates regarding your injuries; it is also possible that you can receive workers’ compensation if you were in a car accident while working.
For a free legal consultation with a workers’ compensation lawyer serving Alhambra, call (310) 896-2723
Making a Workers’ Compensation Claim
The sooner you file a workers’ compensation claim, the more likely it is the claim will be accepted. You will need to determine who your medical provider will be. A primary treating physician may have been selected by your employer before you suffered an injury.
A claims administrator will decide whether to accept your claim or reject it after reviewing the facts. If a workers’ compensation claim is approved, then workers’ compensation funds will pay for medical treatment. If a workers’ compensation claim is rejected, then the applicant will need to possibly file an appeal.
A claims administration will then determine if the applicant qualifies for permanent or temporary disability benefits. If you qualify for permanent benefits, you cannot receive a final determination until a physician confirms that you have reached optimum medical improvement. Lastly, the employer must reimburse you for medical bills, and the claims administrator will pay any disability benefits.
Alhambra Workers’ Compensation Lawyer Near Me (310) 896-2723
Appealing a Denied Workers’ Compensation Claim
Workers’ compensation claims may be denied for many different reasons. If you want to file an appeal, then you should be aware that a lawyer can represent you throughout the appeals process. However, the appeal must be handled in a specific order.
First, you must submit a claim adjudication application. Second, you must submit a Declaration of Readiness to Proceed. Third, your lawyer and the claims administrator must attend a mandatory settlement conference.
If the case is not resolved during the mandatory settlement conference, then the judge will set a date for trial. Once the judge makes a ruling after the trial, you can request that the California Workers’ Compensation Appeals Board reconsider their decision.
Why Employers May Deny Workers’ Compensation Claims
Violations of policies and procedures may cause an employer to deny workers’ compensation claims. Employers will typically give training manuals to employees to reduce the likelihood of workplace incidents occurring. It is essential for employers to review the facts of every workers’ compensation claim.
The following are some of the reasons workers’ compensation claims are denied:
- The injuries were not accidental but were self-inflicted to receive workers’ compensation benefits
- The injuries occurred while the employee was intoxicated
- The injuries were due to the employee ignoring company policies and guidelines
- The injuries were caused by employees fighting or undertaking dangerous activity in the workplace
Employers will often drug test employees after a workplace accident. Also, employers will claim that the injured employee caused their own injuries, and the employer is not liable. If you are denied workers’ compensation benefits, then you should retain a workers’ compensation attorney in Alhambra.
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Workers’ Compensation Laws in the State of California
The Department of Industrial Relations, Division of Workers’ Compensation, handles all workers’ compensation claims in California. Form DWC-1 is provided to employees by their employers. Also, employees have five years from the date of their injury to file Form DWC-1.
Workers in California may be entitled to the following types of benefits:
- Supplemental job displacement
- Permanent disability
- Temporary disability
- Medical benefits
While an employer investigates a workers’ compensation claim, the employee is entitled to up to $10,000 in medical bill reimbursement until a decision about the workers’ compensation is complete. If an employer or insurer fails to deny a workers’ compensation claim within ninety days of its filing, then the claim will be deemed approved. Also, employers must provide temporary disability benefits to employees within fourteen days of learning about an employee’s illness or injuries.
Common Workplace Injuries in California
Workplace injuries can occur during any type of employment. The following are some of the most common injuries employees suffer in California:
- Toxic substance exposure
- Fatal injuries
- Complex Regional Pain Syndrome (CRPS)
- Hearing impairment
- Bone fractures
- Spinal cord injuries
- Traumatic brain injuries
- Chemical burns
If you suffered an illness or injury while acting within the course and scope of your employment, then you may be able to file a workers’ compensation claim.
Workers’ Compensation and Covered Costs in California
Workers’ compensation benefits cover job retraining, lost earnings, and medical bills. If an employee dies during a workplace accident, then the surviving family members will receive death benefits. Lost wages are typically covered through four types of payment systems: permanent total disability, permanent partial disability, temporary partial disability, and total temporary disability benefits.
Retaining an Alhambra workers’ compensation lawyer will help you understand everything you need to know about the worker’s compensation system in California. Also, you can benefit from attorney-client privilege and attorney-client confidentiality if you are represented by legal counsel.
If You Need Assistance with Your Workers’ Compensation Claim, Contact the Simmrin Law Group Today
You may have additional questions regarding your potential workers’ compensation claim. If you are searching for a workers’ compensation lawyer in Alhambra, then contact us today to schedule a free consultation. We have years of experience assisting employees with their workers’ compensation cases.
Workers’ compensation cases are complex, and it can be helpful to have an Alhambra workers’ compensation attorney representing your legal interests. You may want to appeal an adverse workers’ compensation claim decision. No matter what question you have regarding workers’ compensation law, we can help you enforce your legal rights.