Workers’ Compensation In California
2 Types of Claims
California recognizes two different types Workers’ Compensation claims.
- Specific Injury: When you are injured on the job on a specific day, such as falling off a latter, or bending over and injuring your back. Specific injuries are the most obvious kind of industrial injury and there is a specific day you can point to when you were hurt on the job.
- Cumulative Trauma Claims: When you suffer a disease caused by gradual wear and tear or exposure while on the job. Typical examples include carpal tunnel, or arthritis in the back, shoulders, or knees. If your job duties required repetitive walking, bending, lifting, or typing, then often there will be some basis for a cumulative trauma claim. However, these types of claims are sometimes more difficult to prove. Hiring an experienced attorney can make a big difference in cumulative trauma cases. These cases can be brought many years later after the injured worker has last worked.
If you suffer an injury or disease as a result of your job duties, then California law requires your employer to provide:
- Employer-paid Medical Care – including medications and surgery if necessary.
- Temporary Disability Benefits – usually 2/3 of your average weekly earnings.
- Permanent Disability Benefits – typically a lump sum payment at settlement.
- Death Benefits – In addition, if an injured worker’s employment has caused or contributed to his or her death, his dependents can recover benefits.
Deadline to File
The statute of limitations for filing a workers’ compensation claim or appeal in California is typically 1 year from the date of the injury/illness, or 5 years if benefits were provided. However, there are many defenses to a claim if the case was not filed in time. Many times, a case can be won even if it has been many years since the worker last worked, sometimes even if over 10 years. If you have been injured from your job but never filed a claim, you should call Doug, as he has helped many injured workers recover even if it has been many years since the injury.
The Administrative Process
The Workers’ Compensation Appeals Board, not the courts, usually decides whether your worker’s comp claim for benefits should be granted. The administrative decision will be based on what’s in your worker’s comp file with the agency, and the evidence presented at an administrative hearing.
Make sure you provide your lawyer with all the medical information you have, so that your lawyer knows everything you do about your medical condition.If your lawyer asks you to round up information or paperwork, make it a priority to get it done as soon as possible. Your lawyer wouldn’t be asking for the information if he or she didn’t see it as important.
Keep copies of everything you send to your lawyer, and all the hearing paperwork.
Be prepared for a long wait while your workers’ comp claim is processing. It is not unusual for claims to take years to resolve.
An “Industrial Accident” is any accident that happens to you while you are on the job. When you become injured, you should immediately seek medical attention. Avoid “putting it off until tomorrow” to see if you’ll feel any better. There could be serious underlying injuries that may not manifest that quickly, and you could cause further injury to yourself by delaying medical attention.
You have the right to see a doctor, without charge to you, for any accident at the workplace, regardless of how trivial it may seem. Your employer will issue you a form to fill out and return; do this as soon as possible!
In most cases, Workers’ Compensation covers your medical treatments until your treating physician releases you to go back to work doing your normal job. However, there a times when your medical coverage is covered even while you are back to work. These issues are better dealt with on an individual basis with your attorney.
When you’re injured, you should seek the advise of an attorney as soon as possible. When you try to represent yourself, the insurance company is required by their company to offer you the absolute minimum settlement possible, if any at all. In order to protect your rights under the workers compensation laws, you should seek legal advise before signing anything that would, in effect, give up your rights to medical treatment or monetary compensation.
Your employer, regardless of how much he may genuinely care for you as an employee, knows that the longer you are off work, the more it costs him. He or she will want you back on the job as soon as possible; either at your regular job, or some type of modified position.
No Upfront Attorneys Fees
Unlike civil cases or criminal cases, there are no “up-front” fees to be paid to an attorney. The costs incurred by the law firm handling your case are deducted from your settlement and the fees that your attorney receives is dictated by the workers’ compensation board. The fee is usually 15% of any settlement your attorney is successful in winning for you. All fees must be deducted from your settlement and paid directly to your attorney by the insurance company.
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