Apart from affecting your ability to live a comfortable life, work-related injuries or illness can also affect your ability to continue working to support your family financially. Fortunately, under workers' compensation laws, you can file a claim to receive compensation benefits from your employer’s workers’ compensation insurance provider, including lost wages and medical expenses.
Because of the legal complexities involved in this claim process, you should consider working with an attorney to help you gather the necessary evidence to fight for adequate compensation for your work-related injury.
Whether you need to understand more about workers' compensation claims or perhaps, you want to file a compensation claim for your work-related injuries, attorneys at The Workers Compensation Lawyer Law Firm are to help. Underneath, you learn everything you need to know about workers' compensation insurance and what to do after experiencing a work-related injury or sickness.
Workers' Compensation Insurance at a Glance
Under workers compensation laws, every employer must carry workers' compensation insurance, also commonly known as workers' comp, even if they have one employee in their business or company. The purpose of carrying this workers' compensation insurance is to protect you as an employee when you suffer a work-related injury or illness.
If your medical bills are piling up and you already have lost wages due to a work-related injury, you should consider filing a workers' compensation claim as soon as you can. Filing a workers’ compensation claim allows you to receive benefits for all losses associated with a work-related injury or illness.
Everyday Work-Related Injuries That Are Compensable Under the Workers' Compensation Law
If you want to file for workers' compensation benefits, you must be ready to prove that your illness or injury is work-related. According to Labour Code section 3600, any injury that occurs at work or within the scope of your employment constitutes a "worker-related injury."
There are many types of injuries you can suffer in a workplace, depending on the nature of your work. Typically below are everyday work-related injuries that are "compensable" under the workers' compensation program:
Repetitive Motion Injuries
Some of the most common injuries in a workplace are repetitive motion injuries. As the name suggests, these injuries occur due to repetitive actions, for example, typing. If your job involves frequent typing, you might be at risk of a wrist injury due to that repetitive motion on your wrist.
Accidental or Sudden Injuries
Undoubtedly, accidental or sudden injuries are what most people think about when they hear stories about employees filing workers' compensation claims. Accident injuries are also common workplace injuries, especially in a factory or warehouse setting. These types of injuries include:
- Cuts
- Slips and falls
- Contact with harmful or toxic chemicals
- Burns
Stress-related Injuries
Sometimes the strain associated with day-to-day work experiences can become too much to handle. For instance, few day-offs, chaotic working conditions, or extreme pressure can lead to physical or mental injury.
Exposure Diseases
Under the workers ' compensation law, you can still receive compensatory benefits if you develop a health problem due to exposure to harmful chemicals or perhaps excessive sound at your workplace.
Off-Hour Injuries
Off-hour injuries also count as work-related or workplace injuries even if they occur when you are out of your usual work duties, for during a break or employees picnic.
It is worth noting, almost all injuries that occur at a workplace or during the scope of your employment are compensable under the workers' compensation program unless if the injury was a result of:
- Fight
- Horseplay
- A criminal activity
- Alcohol or drug intoxication
What to Do After Suffering Injury a Work-Related Injury
When you suffer a work-related injury, there are steps you must take to protect your interests and increase your chances of achieving adequate compensation. Here are some of these vital steps:
Seek Medical Assistance
If your injury or illness requires emergency medical assistance, you should prioritize your health and talk to a doctor. Even if you do not visit a doctor immediately after the injury, you must do so at some point for the necessary medical care.
If you already have a healthcare insurance plan for health issues unrelated to your job, you can visit your "pre designated" doctor for medical assistance. However, If you didn't predesignate a particular doctor before the injury by filing DWC Form 9783 with your employer, they have a right to choose the doctor you will consult.
Visiting a doctor or physician is vital after suffering an injury in a workplace because, among other services, they will do the following:
- Assist you in determining the date you can return to work
- Assist you in identifying various "light" jobs or activities you can while recuperating or recovering
- Write or type a medical report that will help you calculate the benefits you should receive for your losses associated with a workplace injury
- Recommend you a specialist if they don't have the expertise to fix your health issue
- Testify in court if necessary in an attempt to prove you deserve maximum compensation benefits for your losses associated with a workplace illness or injury
Report Your Injury
If your work-related injury is non-severe or non-emergency, you should report this health issue to your employer before seeking medical treatment. Your employer requires you to do this because they might choose to refer you to a doctor who is part of their medical provider network (MPN).
Typically, you have up to thirty (30) days from the date of your work-related injury or illness to tell your supervisor or employer about your issue. Even though a month might seem like enough time to report your injury, it is advisable to do so as soon as you can because your employer's insurer will most likely be doubtful of your compensation claim.
Because some work-related injuries and illnesses become more revealing and symptomatic over time, it is wise to report an injury to your employer as soon as you notice your first symptom or should've noticed.
File a Workers Compensation Claim with Your Employer
Within one (1) working day after notifying your employer about the work-related injury, they should provide you with a compensation claim form (Form DWC-1) to fill out. If your employer doesn't give you Form DWC-1 within that period, you can download it online from the Division of Workers Compensation (DWC).
When filling out Form DWC-1, you should be keen to avoid providing erroneous or misleading information that may compromise your chances of receiving adequate compensation benefits. For that reason, it is advisable to have an experienced attorney in your corner who may do all this on your behalf to ensure the claim is accurate and detailed as required.
Typically, Form DWC-1 will have an employees' section, requiring you to fill out the following information:
- Time and the date of injury
- Location of the injury in your body and how the injury affects you
- Description and address of the precise location where the injury occurred
- Your social security number
Once you fill out all the required information on the claim form, you should hand it over to the employer or send it to them through certified or first-class mail and keep a copy of it. Upon receiving the claim form, your employer will have one working day to fill out their section and submit the form to their insurance provider. Then, they will hand you over or send you a copy of the claim form via certified mail.
What to Expect After Filing Form DWC-1
Once your employer's insurer receives your claim, they will send you feedback regarding the claim within fourteen (14) days. Your employer's workers' compensation provider may choose to accept, deny or delay your compensation benefits. When they delay your compensation claim, it means they are investigating the claim, which should not take more than ninety (90) days.
If they don't send you feedback regarding your compensation claim, you should contact an attorney if you haven't already. Your workers' compensation attorney will ensure your claim receives maximum attention and consideration during these stressful times.
While waiting for their response, you have a right to seek a medical treatment costing up to $10,000, even if they decide to deny your workers' compensation claim eventually. Remember to keep your medical journal since the date of your injury or illness to strengthen your workers' compensation claim.
To receive your compensation benefits, you might have to resolve your compensation claim against your employer's workers' compensation insurance provider through any of the following ways:
Settlement Negotiation
Just like a personal injury case, you can also resolve a workers' compensation claim out of court through a settlement negotiation. It is vital to have an attorney represent you during a settlement negotiation with your employer's workers' comp' insurer.
Your attorney will know how to calculate the amount you deserve as compensation for all your losses resulting from a work-related injury or illness. Generally, here are two forms of workers' compensation settlements that you need to know before sitting down with the other party for negotiation:
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Stipulated Findings and Award
Stipulated findings and award settlement happen when you and your employer’s workers’ compensation insurer agree to weekly or bi-weekly benefits that you should receive for all your losses and ongoing treatment costs for a work-related injury. However, a judge should decide whether the stipulation is fair or not. If you accept stipulated and award settlements, your employer will continue paying for ongoing medical treatment.
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Compromise and Release
Another settlement alternative to stipulated findings and award is compromise and release. In this case, you and your employer will decide an appropriate fair compensation amount for your claim, which you will receive in a lump sum. At this juncture, your compensation claim is over, and you will not receive weekly benefits for any ongoing treatment.
When you agree to this settlement option, your employer's insurance provider will pay you a lump sum settlement instead of providing you with weekly benefits. The advantage of agreeing to this settlement option is that you will receive your full compensation within a short period.
Before agreeing to any of these settlement options, you should talk with your workers' compensation attorney for advice because both of these options involve complicated factors related to your unique situation. Depending on your financial situation and current medical condition, your attorney will know which settlement option will work out in your favor.
Your employer's workers' compensation insurer cannot also deny your compensation claim if they believe that:
- You have insufficient evidence to prove you have an injury
- Your injury is due to another activity or job
- Your injury isn't work-related
- You can go back to work
- You do not need medical assistance
Filing an Application for Adjudication
Even if most compensation claims settle out of court, some cases will require a judge's intervention to determine whether or not you deserve workers’ compensation benefits. To make your compensation claim official, you will have to file an Application for Adjudication within one year from the date of your injury.
Filing an Application for Adjudication (Form WCAB-1) opens a court case with the WCAB (Workers' Compensation Appeals Board), which involves several legal proceedings. Although you can go through these legal proceedings on your own, it is advisable to have an attorney on your side to protect your legal rights and fight for your best interests.
Having an attorney during this appeal process can increase your available odds of obtaining compensation benefits for your work-related injury.
Employees Entitlement or Benefits for a Work-Related Injury or Illness Under Workers Compensation Law
If everything goes well with your claim, you will receive workers' compensation benefits for your work-related injury or illness. Some of the benefits you have entitlement for include:
Medical Treatment Costs
Your employer workers' compensation insurance provider should pay you reimbursement for all the medical costs you had to incur and will continue incurring due to a work-related medical condition or injury, including
- Surgery costs
- The cost of buying medical aid devices
- The cost of buying prescription drugs
- Medical evaluation costs
- Transportation costs
Temporary Disability Payments
Under the law, if an employee has a temporary disability due to work-related problems, it means they are still recovering and expected to be back to work as soon as possible. Temporary disability payments will compensate you for the lost wages during the treatment or recovery period.
You will continue receiving temporary disability payments for a maximum of two years from the date of your work-related injury. However, if you have any of the following medical conditions, you will receive these benefits for a maximum of 240 weeks:
- HIV
- Hepatitis B and C
- Particular eye injuries
- Amputation
- Severe burns
- Pulmonary fibrosis
Permanent Disability Benefits
If your doctor diagnoses you with a permanent impairment, your life might not be the same again. Fortunately, you are eligible for permanent disability benefits under the workers' compensation law. To that end, if your work-related injury affects your ability to go back to work or secure another job, you have an entitlement for permanent disability benefits to make your life comfortable and hassle-free.
Some permanent injury cases could also attract an award of life pension payments. Life pension payment is a weekly stipend on top of your weekly permanent disability benefits. However, unlike permanent disability benefits, you can receive this life pension payment for your entire life.
Vocational Rehabilitation
Also known as supplemental job displacement benefits or vouchers will help you pay for retraining or skill enhancement expenses if you can't return to your previous job after suffering a work-related injury. Depending on your case's facts, you might receive vocational rehabilitation benefits of up to $6,000 to cater for your retraining costs in a state-approved school.
Death Benefits
When someone you love dies due to a work-related injury or illness, you might also be eligible for death benefits if you were partially dependent on them for financial support. You would be eligible to receive death benefits if you were the employee's close relative or a member of their household. Below are some of the qualifying relatives:
- Spouses
- Children
- Uncles and aunts
- Siblings
- Parents
- Grandparents or grandchildren
- Nieces and uncles
Additionally, the workers' compensation insurance provider should also pay you reasonable funeral costs that you had to spend out of pocket to organize your loved one's send-off ceremony.
Retaining the services of an attorney is the key if you want to increase your chances of achieving adequate compensation for your work-related injury. Your workers' comp attorney will help you collect relevant evidence to support and strengthen your claim.
Hiring a Workers' Compensation Attorney
You cannot undermine the benefits that come with having an attorney on your side when filing a workers' compensation claim. Your compensation attorney will take time to understand your unique situation to know the best possible and viable way to pursue your workers' compensation benefits from your employer's insurance provider.
Working hand in hand with an attorney during the compensation claim process ensures that your claim is accurate and your rights and interests are protected. Below are tips to help you find a dependable workers' compensation attorney without a hassle:
Do Your Homework
Before you embark on your journey to find a workers' compensation attorney to help you on your case, you should do your homework to familiarize yourself with everything you need to know about these legal experts. Use the internet to find a top-rated reputable workers' compensation attorney within your area of residence.
Typically, a reliable attorney will have their reputation precede them. To know whether or not your prospective attorney is reputable, you should visit their social media channels or website to read their past client testimonials or reviews about their services.
Another way to find a reputable workers' compensation attorney is by seeking recommendations from your friends, relatives, and co-workers. Your friend's recommendations will reduce your options to find a reputable attorney without a hassle.
The Attorney's Experience in this Field
Ensure you find an attorney with significant experience handling workers' compensation claims for different clients because laws keep changing. An experienced attorney will know the ins and outs of submitting a workers' compensation claim to ensure maximum compensation benefits for your losses associated with a workplace injury.
Additionally, it's also essential to know whether or not they have experience representing clients with a work-related injury or illness similar to yours, especially if your case is unique in some way. An attorney who is familiar with injury cases like yours will know which pieces of evidence will best work out in your favor to win adequate compensation benefits on your claim.
The Attorney's Proactiveness and Positivity
Find an attorney you can be sure will work hard to represent your interest and fight for your rights relentlessly. If your prospective attorney isn't optimistic about winning your workers' compensation claim case, you should consider finding another dedicated legal expert.
Generally, a proactive and positive attorney can assure you of the best legal representation during the whole claim process.
The Attorney's Personality
Finally, it is also essential to find an attorney you can trust and have open communication with during the claim process. Before you settle for the services of your prospective attorney, you should consider their personality to know whether or not you're compatible with them. Stay away from a rude attorney because that is a sign of unprofessionalism and unreliability.
The Attorney's Cost of Services
Since attorneys will typically charge different costs for their services, you may want to research this issue before you settle for the services of any workers' compensation attorney. Typically, most attorneys will charge you less than 20% of the total compensation benefits you will receive if your case is successful. Take your time to shop around for an attorney with a fair cost of services.
Find a Los Angeles Workers Compensation Attorney Near Me
A work-related injury or illness can suddenly alter your career path and your whole life. At The Workers Compensation Lawyer Law Firm, we understand what you might be going through if you have workplace injury. Our attorneys are here 24/7, ready to help you seek total compensation for your work-related injury or illness.
Call us at 424-501-9228 to schedule an obligation-free consultation with our understanding and caring attorneys wherever you're in Los Angeles, CA.