Workers’ compensation provides California workers with benefits in the event that they suffer an injury on the job or develop a job-related illness. The best way the employees can ensure that they get the benefits they deserve is to educate themselves about the workers’ compensation program and retain an experienced attorney to represent them. Here are 7 things you need to know about California workers’ comp. For more information, call our office today to speak with a workers’ compensation attorney in California.
Typically, You Can’t Sue Your Employer for Negligence
In most cases, injured workers are barred from suing their employers. This is the downside to being able to get benefits regardless of whose fault an accident was. In other words, filing a workers’ compensation claim is almost exclusively your remedy, with very few exceptions. You can usually only file a lawsuit if there has been some sort of deliberate action by the employer to harm you, such as an assault or removing the safety guards on certain machines.
You can file a lawsuit against a third party, such as another contractor or a work equipment manufacturer if they were to blame for your injuries. This could include a negligence-based personal injury lawsuit against someone else or a product liability claim. Then, you could receive your full lost wages and payment for your pain and suffering.
You May Be Entitled to Permanent Disability Benefits
Workers’ compensation can make permanent disability payments to you if you are unable to work. This would be based on the disability rating for your injury that you receive from a treating doctor. This is not based on your future earnings capacity but only on your present earnings. If you have reached the point of maximum medical improvement, your doctor will write a report that describes your injury as “permanent and stationary.”
You will receive a disability rating after evaluation of your condition. This will be applied to your earnings to calculate your benefits. Injured workers are almost never rated at 100%. Most often, they are rated at far less than that. Disability ratings are one common area where people need a lawyer because they may disagree with the rating that they have received. You can ask for your disability rating to be reconsidered or appeal the rating to a judge.
You Have Options When it Comes to Payment
You have two options for collecting your permanent disability benefits:
● Stipulation and award – this is when you have an ongoing relationship with the insurance company, and they pay your benefits progressively over the course of your claim. This includes both your medical benefits and wages. You have the ability to keep working at the same employer when you return to work and to reopen your claim if your condition worsens.
● Compromise and release – this is when you agree to a one-time lump sum settlement. You are paid now for both your lost wages and medical costs.
This releases the insurance company from any further liability with regard to your claim. There is no more claim, so it cannot be reopened.
If you have a large workers’ compensation claim, you should consult with an attorney about which option may work best for your situation. If you should choose to accept a lump sum settlement, the attorney can help negotiate it with the insurance company.
The Time Limit to File a Claim Can Start when You Discovered Your Injuries
The deadlines for your claim begin to run at the time when you knew or should have known that you were injured. This is important because some workplace injuries are either not apparent right away or are not discovered until years later. This covers things such as exposure to toxic substances and repetitive motion injuries. Of course, the insurance company may try to use this as a basis to reject your claim. They are often looking for reasons to deny claims, and timeliness is one of their usual justifications for denial. You have one year from the time that you discover a disability to file a workers’ compensation claim when the injury results from cumulative trauma.
You May Have Options Even if Your Claim is Denied
There is some protection for people who receive medical treatment for their workplace injury and then have their claim denied. California law provides that people who get treatment while their claim is pending can still receive $10,000 for that treatment, even when their claim is denied. However, given the high cost of medical bills, this is not a large amount of money. Therefore, you have every reason and incentive to appeal a denial.
You May Be Able to See Your Own Physician
It depends on whether your own doctor is a part of your employer’s Medical Provider Network (MPN). If the answer is yes, then your doctor can treat you. If not, you must use a doctor that is in the network. Your employer must provide you with information about its MPN in order for you to have an obligation to use it. Also, you will not be required to see a doctor for treatment if they do not live within a reasonable distance of your home. Therefore, if there is no doctor in the MPN that is within that reasonable distance, you can see your own doctor. Not being able to choose your own doctor is a common complaint that people have with the workers’ compensation system.
Your Employer Cannot Discriminate Against You for Filing a Claim
California employers are forbidden from discriminating against employees who have filed a workers’ compensation claim. They cannot even threaten to fire you. Adverse action does not just extend to termination. Any type of discrimination is prohibited. If you have been fired, you should receive back wages, increased compensation (up to $10,000), and reinstatement to your position. Document everything that happens with your employer after your injury in case you need to file a claim for discrimination.
Call Us Today to Speak with a Los Angeles Workers’ Compensation Lawyer
If you have been injured at work, you need legal advice from an attorney. This is even more pressing if you have filed a workers’ compensation claim and it has been denied. Call the Arshakyan Law Firm at (888) 851-5005 or contact us online to schedule a free consultation to discuss your case.