Overview of Workers Comp

If you have been injured on the job, you’re entitled to financial rewards pursuant to workers’ compensation law. California has its special judicial system and separate procedures to handle cases regarding work-related injuries.
All California employers are required to have workers’ compensation insurance. Failure to provide such may lead to criminal and civil penalties for the employer.

There are various entities involved with workers’ compensation. Once you suffer a workplace injury, you’ll go to a workers’ compensation insurance carrier. If there is a dispute with your compensation claim, you’ll talk to the Workers’ Compensation Appeals Board.

It can be stressful dealing with all these while you await the medical treatment because you’ve been injured at work. It’s best to have someone with you who understands the workers’ compensation system and the process. One mistake can cost you your workers’ benefits, making your medical bills higher while you suffer from lost wages from your inability to return to work. Talk to an Upland workers’ compensation lawyer for a better chance with your injury claim.

How to file workers comp claims?

Your work-related injury falls under the workers’ compensation coverage if it requires more than just first aid or if you need more than the day of your injury to recover.

First aid is a one-time treatment and follow-up visit for minor injuries such as scratches, burns, splinters, cuts, and other injuries that do not normally require medical care.

Do I need to tell my employer?

Workers compensation laws require the injured employee (you) to notify their employer in writing within 30 days of the work injury. However, if they find out in some other way, like if your coworker tells a manager, then that works, too. You can still recover your workers comp benefits even if you failed to inform them unless the delay caused some negative effects on your employer.

Within one day of being notified of the injury, your employer has to provide a Claim Form. On this form, you’ll have to note down details of the incident and your signature. Be sure to fill it out correctly. Any inaccurate information can be a reason to deny your claim or be taken as workers compensation fraud.

Other Notices for Workers Compensation Claims

After you give your employer the completed form, they’ll send it to their insurance company. In turn, the insurer will have to notify you of your different employee rights, such as:

How long after my job injury can I file my claim to get insurance benefits?

An insurance company can deny your medical benefits if you exceed the statute of limitations. The limit is usually one year, with a few exceptions. The one-year period begins at the date that whichever of the following occurs latest:

• The last medical treatment
• The last payment of disability benefits
• The date of injury

It’s best to talk to a workers compensation attorney as soon as you can. If you delay, the statute of limitations may pass and you won’t be able to claim your benefits under the compensation policy. Consult our Upland workers compensation lawyers ASAP!

However there is an exemption: if the employer does not inform the claimant of the right to file a claim for an injury arising in the workplace, then the statute of limitations does not apply and does not take away entitlement for benefits.

How will the insurance company investigate my claim?

Insurance has ninety days from the date of filing to decide if your claim is compensable. If they don’t deny, then the claim becomes accepted.

Until they accept or deny your claim, you’re entitled to medical treatment of up to $10 000, no matter if they decide to deny the claim.

The insurers may place you under oath during a deposition to ask you questions about the incident and your injury. They may have you take a medical examination from their chosen medical provider. They may get records from your prior treatment and employment through a subpoena.

If your claim gets denied, insurance will have to send you a Notice of Denial. If you want to appeal, you have one year from the date of the notice. Talk to our California lawyers to get the benefits you deserve for your workers comp case.

Final Thoughts

Insurance companies are not on the side of injured workers. It’s difficult to claim your workers compensation benefits if you’re still recovering from your workplace injuries and dealing with medical expenses while the insurance tries to find a way to deny your claim.

The Upland workers compensation attorneys at the Law Offices of Marc Grossman know how to negotiate and litigate these claims so that victims can get the reimbursement they deserve. We have 18 years of experience serving our clients with their workers compensation claims.Call our Upland workers compensation office now to get you the medical benefits you deserve.

The quick spread of the disease known as COVID-19 has affected businesses all over the country. Employers struggle to protect the health of the employees who remain, as well as how they can assist those who’ve contracted the virus due to work-related exposure and how they could return to work.

You or a loved one may be worried about the cost of the medical bills and medical treatment. Does workers’ compensation law grant you work comp benefits if you’ve contracted COVID on the job? We’ll tackle this in the article below.

An Overview of Workers’ Compensation

Often shortened to “workers’ comp,” it is a government-mandated benefit system that gives monetary benefits to employees who lost wages or incurred medical expenses and other expenses due to work-related illnesses and accidents. Workers’ compensation laws also cover death benefits for the families of the deceased employee.

According to the US Occupational Safety and Health Administration (OSHA), an illness or injury is work-related if an event or exposure in the work environment caused or contributed to it. Typically, your workers’ comp lawyer has to prove that the employer is liable for the workplace injury and thus, their client is entitled to monetary benefits.

For more compensation information, contact a workers’ compensation lawyer.

Workers’ Compensation for Occupational Diseases

An occupational disease is one contracted due to exposure to risk factors while working. If you get one, you’re entitled to workers’ compensation insurance benefits. First, you must prove that:

• The disease manifested itself
• The employee was disabled from working and has lost time in employment due to the disease
• The employee has reasonable grounds to suspect that it’s related to their occupation

To win your workers’ comp claim, a professional must make a medical examination to formally diagnose you with the disease. Besides, you or your legal representation must show that you were disabled and thus, are experiencing pain and suffering from the disease. You must also show that you contracted the disease due to conditions from your employment, not just from being in the general public.

Contact a law firm specializing in personal injury claims, workplace accidents to get assistance from workers’ compensation attorneys.

Workers’ Comp for COVID-19

As with any other occupational illness claim, merely having COVID-19 does not entitle a worker to compensation. You need a physician to diagnose you with COVID-19 and some form of proof that your exposure to the virus was due to employment-related circumstances. Workers’ compensation lawyers know what exactly a claimant needs to help with their case to prove their entitlement for compensation.

A problem that workers’ comp claimants may face is that this is a pandemic. There is a significant risk of contracting the virus just from being with the general public. The average employee will likely face a denial of their workers’ compensation claims.

It differs with each workers’ comp case. A skilled workers’ comp attorney can give you legal counsel on whether your claim can get you medical benefits from workers’ comp law.

The outlook of a compensation claim is much better for those considered as frontline workers. Healthcare professionals, first responders, and some travel industry professionals are at greater risk of contracting the disease and have a better chance of getting their workers’ comp benefits.

Hire a Lawyer to Help

In normal times, workers’ compensation is a complex area of the law; COVID-19 only adds to the complexity of the legal issue and you need an attorney to help.

To summarize the article, a frontline worker’s compensation claim has a higher chance of being approved. For those whose jobs don’t involve high-risk exposure, it may be quite difficult, but not impossible, to get benefits from the claims.

The bottom line is that if you’re a healthcare worker, first responder, or otherwise your occupation places you on the front lines of facing the coronavirus outbreak, your workers’ comp claim could very well be approved. It’s much more difficult, but perhaps not impossible, for those whose jobs don’t involve an especially high risk of exposure.

This situation is constantly evolving. Contact an experienced workers’ compensation attorney for up-to-date information and help get compensated with your case.

The personal injury lawyers from the Law Offices of Marc Grossman are there for your workplace injuries and getting your workers’ compensation benefits. If you’ve been injured at work, don’t hesitate to contact us. Our personal injury attorneys are ready to fight for you. Call 855-5664-911 or complete our contact form for a free consultation.

How To File A Workers Compensation Claim in California

Workers’ compensation is insurance paid by companies to provide benefits to employees who become ill or injured on the job. Through this program, you are not expected or required to contribute toward this expense. It provides for the cost of medical expenses and lost wages should you become injured or ill as a direct result of your job. According to California workers compensation laws, neither you nor your employer is considered to be at fault if you file a claim. Workers’ compensation is a no-fault system in which benefits are paid for injuries on the job regardless of fault. That means that your claim will not be diminished if you were at fault. By the same token, it will not be increased if the employer is to blame.

Your claim will be paid if your employer or their insurance carrier agrees with you that you sustained work-related injuries or occupational disease. In cases of dispute, you do not receive any payments until a workers compensation law judge decides whether you or your employer are right. You might still be eligible for disability benefits, however, until the outcome is decided. If you can go back to work but cannot earn the same level of wages due to your work injury, you might be entitled to two-thirds of the difference between your former and current wages.

How Do I Know If My Illness or Injuries Are Compensable?

As soon as you develop a job-related illness or if you were injured at work, you can file a workers comp claim. The sooner you do it, the better since the employer’s insurance company can deny delayed requests. If your illness or job injuries developed over months or years, you should file a claim as soon as you recognize that the situation is work-related and as soon as you saw a doctor or took time off because of the illness or injury.

Assuming you have already received medical attention, the workers compensation claim process involves several important steps. You must notify your employer in writing; fill out an official claim form (which should be provided by your employer), and keep detailed records about your treatment.

The workers comp claim process is discussed in greater detail below.

What Should I Do If I’ve Been Injured?

• Get Immediate Medical Attention

If you have been injured, you should first seek emergency medical attention. Some workers compensation policies require injured employees to go to an approved medical provider or your predesignated physician and tell them that your injury or illness is job-related. Even if you do not feel the need to get medical attention, it may be a requirement for the workers compensation claim process. Keep in mind that a medical report will serve as an official record of your injuries and the basis for any workers’ comp reimbursement.so make sure t get the medical report from the accredited medical provider.

• Notify your employer

Unless you have a medical emergency, do this before seeking medical treatment, as your employer may refer you to a physician who is part of its medical provider network Make sure you notify your employer about the injury within the statutory deadline, preferably soon after the injury occurs. As with any legal process, make sure you notify your supervisor in writing. Even if you give verbal notification first, a written follow-up notification will provide an official record. The sooner you do this, the more details you will be able to recall. In California, you have 30 days in which to notify your employer about a job-related injury. If you fail to report your injury within 30 days, you might lose your right to collect workers comp benefits.  It is a good idea to report all workplace accidents even if you don’t suspect an injury, just in case an injury is discovered after the deadline expires.

• File the required forms.

After notifying your employer and after you have received treatment, your employer then has one day to give or send you a claim form, but you can also find the workers compensation form online. Fill out DWC (Division of Workers’ Compensation) Form 1, making sure to include all the parts of your body you feel may be hurt or affected by your workplace injury or illness. Keep a copy of the completed form as your receipt and ask your employer to return the form to you with the employer section completed. By law on workers comp claims in the state of California, your employer has 24 hours to return the completed form to you. Your employer will then forward the completed claim form to the insurance carrier. .You will also need to file an Application for Adjudication of Claim within one year of your injury to officially file your workers comp claim.

You generally have one year to submit your claim form back to the employer, and you should do so in person or by certified mail.

Generally, you will need to provide the following information on your workers comp claim form:

• Describe the workplace injuries sustained and parts of the body affected;
• Date, time, and place where the injury took place;

What Happens After I File My Claim?

Most of your involvement with the workers compensation claim process is complete after filling out the necessary paperwork. But you still want to follow up on your claim and make sure you keep detailed records. For instance, you may want to keep a record of how the injury affects your work and day-to-day activities. Also, be sure to keep receipts for expenses incurred and proof of any other hardships caused by the injury.

What Should I Do if My Claim Is Denied?

Your claim may be denied because of any of the following conditions:

• There was a delay in filing the claim
• The injury was unrelated to work because it was caused by a “preexisting condition.”
• The injury happened offsite and outside of work
• There is insufficient medical evidence of an injury
• There was  no effort  to get medical treatment, or
• The injury is not severe enough or is not recognized by California law

In most cases, you may still appeal if your claim is rejected. You have the right to have your case heard by a judge. If you disagree with your employer or insurer about a benefits decision, including the denial of your claim, you can file a Declaration of Readiness to Proceed with the Worker’ Compensation Appeals Board (WCAB). You must also serve this form on your employer’s insurance company and include a proof of service form. The Appeals Board will hold a hearing and make a determination on your claim. Your case will be scheduled for a mandatory settlement conference and if the case is not settled there, you will have to prepare documents describing the dispute, identifying what you will present at trial, and give the names of witnesses who will testify.

An experienced injury attorney in Upland can help you prepare the appropriate documents, file on time, and represent you in front of the administrative law judge. If you disagree with the judge’s decision after this trial, you may file a Petition for Reconsideration.

Do I need a lawyer to help me with my workers compensation case in California?

Every workers compensation claim that is paid out is an expense for the insurance company. As such, they will exert all efforts to lowball you, or worse, avoid settlements altogether. It is important to seek legal counsel in order to be fully informed of your rights and the benefits you are legally entitled to as compensation for your workplace injury or occupational illness. Undoubtedly, workers comp claims are very complicated. An experienced lawyer is familiar with the California judicial system as well as the complexities of workers’ compensation law. No one, not even supervisors or family and friends who have received benefits in the past, will be as qualified to make recommendations to you about settling your case. Putting matters in the hands of someone who is not knowledgeable about workers compensation laws can be a very expensive mistake in the long run. A workers compensation lawyer will fight for the protection of all of your rights under the California Worker’s Compensation Act.

You may think that hiring an injury lawyer is expensive  On the contrary, the most that you will shell out will be 20 percent of the settlement and sometimes less. You pay only if you win and contribute nothing up front. Since lawyers get compensated based on a percentage of the settlement, they are highly motivated to help you get the maximum amount of the benefits you so rightly deserve.

Contact an Upland Workers Comp Attorney

At the Law Offices of Marc Grossman,  we will help you to determine if you have a legitimate case. We will never charge you unless we help you win your case, and your initial consultation is absolutely free. Call us now for a free case evaluation.