Workers Compensation Archives | Experienced Attorneys Upland

Apr 30 2019

Workers Compensation Claim in California

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.

Aug 29 2015

Preparing for Your Personal Injury Deposition

Ten Steps to Prepare for Your Personal Injury Deposition

First things first…

What is a deposition?

A deposition is a question and answer session with the other side’s attorney under oath. The defense attorney will ask you questions and you will answer. A court reporter will take down everything that is said and occasionally they will be video taped.

Why do I have to do a deposition?

A deposition is part of the discovery process in personal injury litigation. Both the defendant and plaintiff have the right to discover what facts and evidence the other party may use in their case. You, as the plaintiff, have a duty to tell the defendant what you know and what evidence you have to support your case and vise versa.

What kinds of questions will they ask?

The defense attorney in a personal injury case will typically ask the Plaintiff many questions regarding the following areas:

General background information such as name, address, date of birth, who is in your family, education, work history, etc.
Information about your physical condition before the injury occurred. For example, in a slip and fall case where you broke your left arm, the defense lawyer is going to want to know if you are left handed or right handed, and he or she will want to know if you had any problems using that arm before the accident.
Information about the accident – how did it happen? Who were the witnesses? Did you talk to anyone after the accident? What did they say?
Information about your medical treatment and physical condition after the injury occurred. For example, What injuries did you sustain in the accident? Who treated you? Did you go to the hospital? Did you see your family doctor? What did the orthopedic doctor do? How long did you have to stay home from work after your surgery?
Information about the impact of the injuries on your life. What are you no longer able to do? What are you able to do but only with difficulty?

OK, now on to the 10 things…

1. The questioning at your deposition will be similar to the questioning in court.

Legal questioning is not something that most people are accustomed to and it can make you feel under attack or cause you to be confused. The important thing is that you try to maintain control. You can control the pace of the questioning by pausing to think about your response before you respond.

2. Make your responses concise.

You paused and considered your answer but before you open your mouth, reduce your response down to the most direct and concise answer possible. Your answer should be only a sentence or two and not a 10 minute dissertation.

3. Dress to impress.

The defense is going to be sizing you up to determine what kind of witness you will make. A confident plaintiff who is dressed appropriately will appear to be a better, more credible witness than one is shorts and flip-flops.

4. Give honest and accurate answers.

It is important that your answers be honest and accurate. Do not give the defense attorney the answer you think they are looking for or exaggerate your response. Doing so will work against you and may result in you being discredited as witness.

5. Eat, drink and use the restroom.

A deposition can cause all sorts of anxiety and nervousness. One way to combat these feelings is by making sure that you are comfortable and not fatigued or doing the “pee-pee” dance. If you need water, food or restroom ask for it or ask to take a break. If you you deposition goes on for several hours and you are feeling fatigued, ask if it can be continued to the follow day or another mutually agreeable day. The important thing to remember is that if you are fatigued or uncomfortable, you are more likely to provide inaccurate answers or get tripped up by the defense attorney.

6. It is OK to say “I don’t remember”.

Never guess, not even if it seems like you should know the answer. If you are not 100% sure and confident that you are providing accurate information, the best and only answer that you give is “I don’t remember.” You cannot be forced to answer a question that you do not know, so “I don’t remember” is a perfectly acceptable response. However, if you do know the answer but you feel as though your response may damage your case, do not say “I don’t know.” You are under oath and sworn under the penalty of perjury that you will tell the truth. Lying or withholding information under oath has legal consequences that you do not want to deal with and may ruin your case.

7. Its OK to say “I don’t understand.”

No one likes to admit that they didn’t understand a question but if you don’t speak up and say “I don’t understand” you are making a big mistake. Lawyers get paid a lot of money to use big words and confusing rhetoric in an attempt to get a witness to provide contradictory statements or other responses that may be used later to make them appear unreliable as a witness or to discredit them altogether. If you don’t have a clear understanding of the question, let the defense attorney know. He or she will reword the question or give you an explanation.

8. It is not always black and white or yes and no.

The defense attorney will try to pin you down and ask question in which they ask you to provide a yes or no answer when there is no yes or no answer. You cannot be forced to answer a question either yes or no if yes or no is not the way that you would answer. If you feel as though a question needs a more elaborative response than yes or no, you provide the best answer. You attorney will support you and make sure that you are not bullied into giving a response that pins you down to yes or no.

9. Ask to see records and reports.

Defense lawyers will often refer to a report or record when asking questions but they won’t always go out of their way to show you that record or report. But, if the defense attorney refers to any document, you have the absolute right to see that document and to review it before responding. Do not assume that you know the contents of the documents in question even if you have seen them before. Ask for the document and then take your time to read through it and know the contents before you answer. Do not provide opinion, just facts to your own knowledge. If the document cannot be produced or they attorney will not give you the opportunity to review it, you simply say, “I cannot answer that question until I have had the opportunity to review the document.”

10. Don’t let medical records be your undoing.

Be aware of what is in your medical records, particularly your medical records from before the accident. If you are making a claim for low back pain and a herniated lumbar disc from a car accident, you should know whether there are any documented complaints of low back pain in your medical records in the five or ten years before the accident. Your attorney should have most or all of your medical records. Ask to review the pre-accident records and talk to your attorney about any prior, similar complaints.

Aug 27 2015

How to Damage Your Personal Injury Case with Social Media

Facebook, Pinterest, Twitter, Google+ and dozens of other social media sharing sites offer us countless ways to share every moment of lives with the world. We have become so comfortable with Instagram, Snapchat and the others that we don’t think twice before posting a photo of ourselves rock climbing in Southern Utah while our attorney is in court arguing that your back injury has caused you to be permanently disabled. It may sound ridiculous but search for personal injury and social media and you will find dozens of cases where the plaintiff had their case dismissed because they posted a picture of themselves in a karate tournament, playing tennis, lifting heavy furniture or similar acts of physical prowess when they have alleged debilitating injuries in their lawsuit. Even a photo of yourself holding your child and laughing can be twisted into something that works against you especially if you are claiming that you have so much back pain that you cannot work.

Here are 10 specific ways that you can damage your personal injury case with social media.

1) Posting details about your accident.

This includes tweets but especially Instagram and Facebook. If you post pictures and details of your accident online you are inviting the insurance company to examine those posts to find defects in your case. Also, avoid chats and other forms of online communications with your friends. Not only does this open the door to other side to discredit you as a witness but also by sharing important details with people who are unrelated to your case you are turning your friends into potential witnesses. Imagine you were kidding around and said, “I am going to make millions off these losers for a couple of bumps and bruises.” Even if you were joking, written text does not translate in the same way as spoken word. That statement could damage your case and sour a jury against you.

2) Posting photos of yourself.

OK, we already mentioned this above but clearly people are not getting the message. If you have a personal injury case do not post pictures of yourself online. Let’s look at one case specific case where the plaintiff was run over on the freeway by a semi-truck while riding his motorcycle. He was seriously injured and confined to wheelchair while his broken pelvis healed. He went from very active to sitting in front of a computer posting pictures on Facebook all day. Unfortunately for him, he posted photo’s of himself doing “stunts” on his motorcycle just a couple of days before the accident. Even though when he was struck he was riding his motorcycle in a safe manner, at trial, the defense presented the photos of him performing stunts. You could see on the faces of the jury that they had turned against him. Ultimately, his award was far less than what it could have been.

3) Playing Online Video Games All Day.

If you think that online gaming is not a form of social media, you are wrong. Part of the online gaming experience is the various ways that you can interact with other people online. Chats, instant messages, profile messages and other exchanges in gaming systems on Steam and other like are just as much social media as Facebook. Your comments, posts and chats on gaming platforms is actually easier to get than comments, posts and chats on Facebook. A jury may not like the fact that you were playing video games 12 hours a day but trying to claim that you are too injured to return to your job as a bookkeeper where you only sit a computer for 8 hours per day.

4) Complaining about everything.

Perception is everything. Many counties in California are chocked full of lower income people, retirees and unemployed people right now and they frequently end up on juries. These are all fine, hard working people with good intentions. But imagine them reading post after post of you complaining about your job and how much you don’t want to go back to work, how small your house is and how you can’t wait until you get your millions in your settlement, how do you think you might be perceived by the jury? Not very well is the answer.

The Bottom line.

Take a break from social media. Pick up the phone or write a letter. There is still a possibility that those could be used against you but they tend to be a much more private form of communication that is not readily available to a defense attorney for the insurance company.

Aug 20 2014

Cops: Beauty pageant contestant lied to get workers’ compensation

Sounds like this contestant needs to call the Law Offices of Marc Grossman for criminal defense today.

RIVERSIDE, Calif. – Officials say a 22-year-old beauty pageant contestant has been arrested in California after being caught on video walking comfortably in high heels while collecting workers’ compensation benefits for a broken toe.