California law requires employers to provide certain benefits to employees that are injured at work. These benefits may include medical treatment, temporary disability, permanent disability, or even death benefits. Unfortunately, insurance companies are good at one thing – making money by denying you benefits.
We understand that a work injury can be one of the most stressful and frustrating experiences you can go through. Allow us to fight the insurance company on your behalf, so you can concentrate on healing. Best of all, our fee is contingent on a successful outcome. In other words, we only get paid if you do. Call us today for a free consultation.
What should I do if I’m injured at work?
First, report the injury to your employer/supervisor. Next, seek medical treatment. Most employers have a specific doctor or clinic that handles work injuries. Of course, if your injury is serious or life threatening, immediately seek treatment at the nearest emergency room.
Don’t forget to complete all paperwork provided by your employer. Within 24 hours of reporting the injury, your employer is required to provide you with a claim form. The claim form must be completed and returned within a certain timeframe, so make sure you do so as soon as possible.
What benefits can I receive?
Depending on your situation, you may be entitled to receive the following benefits:
Medical treatment – Employers and insurance companies are required to provide medical treatment to injured workers. The type and scope of medical treatment depends on your specific injury. Insurance companies often use a process called Utilization Review to deny medical procedures, even if it is recommended by your doctor. You can appeal a Utilization Review decision, but there are specific timeframes and procedures that need to be followed. We can help you navigate the maze of receiving the medical treatment you need.
Temporary Disability – If you miss time from work due to your work injury, you are entitled to Temporary Disability benefits. This benefit functions as a wage replacement to help you pay your bills while you are healing. Temporary Disability benefits are generally equal to two-thirds (2/3) of your Average Weekly Wages, and are paid every two weeks.
Permanent Disability – If your work injury causes permanent disability, you are entitled to compensation. The idea is to compensate you for lost earning capacity due to residual disability. In other words, if you have a permanent disability, you will not be able to function at the same level as you did before the injury. In fact, you may no longer be qualified for certain jobs due to your new physical limitations. Permanent Disability benefits are designed to compensate you for these changes.
Supplemental Job Displacement Benefit – This benefit allows for you to be re-trained for a new profession, if you are no longer able to work at your current job due to your permanent physical restrictions.
Death Benefit – Dependents of workers that are killed on the job may be entitled to a death benefit. In addition to burial costs, a death benefit is a statutorily determined amount that is designed to offset some of the lost income of the deceased. The amount depends on the circumstances and number of dependents. These cases can often be complicated, and consultation with a qualified legal professional is recommended.
In addition to the above, you may also be entitled to reimbursement for things such as out of pocket medical expenses, mileage for travelling to and from medical appointments, medical devices, and home health care. We are more than happy to provide a free consultation in order to discuss what benefits you may be entitled to receive. We will also fight to help you recover benefits that are being improperly denied.
The insurance company denied my claim, now what?
Frequently, insurance companies will deny claims with little or no reason. Although each situation is different, they may be denying your claim in hope that you will simply go away. Don’t allow them to win without a fight. Our office is skilled at collecting the evidence necessary to prove your case and force the insurance companies to provide benefits for which you may be entitled.
There are also ways to receive the treatment you need from doctors on a lien basis while you claim remains denied. There are also options for receiving state disability benefits to help when you are not working. Once the insurance company finally accepts the claim, it is then their responsibility to pay back the treatment liens and reimburse state disability.
I’m not happy with the results of my medical evaluation, is there anything I can do?
It’s not uncommon for an injured worker to be told by a medical evaluator that there is nothing wrong with them, even though they are still too hurt to work. The medical evaluation and the doctor’s reporting must meet certain legal requirements. If they don’t, it is possible to have the doctor disqualified. Even if these requirements are met, an experienced attorney can challenge the doctor’s opinion through a deposition or supplemental reporting. If you are not happy with the report, allow us to challenge it on your behalf.
What if my I am not a citizen, can I still file a claim?
Under California law, employers and insurance companies cannot deny benefits based on your citizenship status. Since we also practice immigration law, we can help you navigate through any potential pitfalls, and help set your mind at ease.
Can I be fired if I file a claim?
One of the most common reasons injured workers do not file claims is the fear of being fired. It violates California law for an employer to discriminate against an injured worker for reporting a work related injury. This includes retaliating against the injured worker by firing them. In fact, if you were fired for reporting your work injury, you may be entitled to additional benefits, including back wages.