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Getting injured is never a pleasant experience. Thankfully, if a person is injured while at work in California, they have the right to apply for workers’ compensation benefits.
All workplaces that have at least one employee are required to carry workers’ compensation insurance so all people who are not self-employed qualify. Usually, workers’ compensation claims are filed, treatment is received, and benefits are paid without a problem.
However, if a worker is unsatisfied with the insurance company’s findings, or the employer disputes the benefits to be paid, either party can appeal the result.
A California workers’ compensation lawyer can represent individuals in appeal situations to either defend their benefits, or to make sure the benefits that they deserve are issued. Get in touch with a skilled job compensation attorney who can help you and your case right away.
California Workers’ Compensation Procedure
Notify Your Employer or Supervisor
Workers cannot be fired or otherwise retaliated against for filing a workers’ compensation claim. California law requires that this be done within 30 days of the accident, but it is best that a worker inform their employer immediately.
See a Doctor
All medical treatment, after an emergency room visit, will be provided by a doctor selected for the worker by the insurance company. This treatment cannot be provided until the necessary paperwork is filed.
Doctor Contacts Insurance Company
The doctor will ultimately provide their opinion on the worker’s ability to return to work and any permanent effects that the injury has on the employee’s work future.
This opinion is sent to the insurance company and payments will commence if a worker misses time at work, will continue to miss time at work, or suffers a permanent harm.
Contact a California Workers Compensation Attorney
Once this determination is made, either the worker or the employer has the right to appeal the findings to a local district office for a hearing. That hearing may then be appealed again to a local appeals court for review. Individuals should then reach out to experienced California workers compensation attorneys for help pursuing their claim.
Reasons for an Appeal
Either the employer or employee may request a hearing office review of the case. Employees will generally appeal a finding which states that they may immediately return to work, or that their injury did not result in any permanent loss of ability to work. Employers may argue that the injury did not happen while the employee was “at-work” and thus payments should not be issued at all. The concept of “at-work” means that an employee was on the clock at the time of the injury and performing work duties.
Commuting to work, lunch breaks, and horseplay are examples of time spent in an activity that will not be considered “at-work.” If the injury is found to occur while not at-work, workers’ compensation benefits cannot be paid.
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If you recently suffered an injury at work, you are likely eligible for workers’ compensation benefits. You could also be eligible for benefits if you have developed an illness related to your job.
When you have been hurt at work, you will have to deal with more than your physical injury. Medical bills can pile up even for seemingly minor injuries.
Workers’ compensation can help you get the medical care you need to cope with these injuries. Workers’ compensation benefits can also reimburse you for a portion of your wages during your recovery period.
Contact a California Workers’ Compensation Attorney Today
A workers’ compensation lawyer can represent an injured worker who wishes to appeal the initial findings of the insurance companies. The attorney will file the necessary paperwork with the district appeals offices and argue the case in person to get the worker the benefits warranted by their injuries.
The lawyer also represents individuals whose benefits have been outright denied, either as a result of insufficient medical evidence for disability, or for employers’ allegations that the injury did not happen while “at-work.”
People who have been denied benefits from the outset, or whose benefits are being threatened by an employer-driven appeal should contact a lawyer today. A California workers’ compensation lawyer will work to get you the compensation that you deserve for your workplace injury.
California Workers’ Compensation FAQs
What types of injuries qualify for workers’ compensation in California?
Workers’ comp covers a broad range of job-related injuries, including acute injuries like falls, crush injuries, burns, and lacerations, as well as repetitive stress injuries (RSIs) such as carpal tunnel syndrome or back strain. Occupational illnesses caused by exposure to chemicals, noise, or infectious agents at work also qualify. Even preexisting conditions can be covered if your work aggravated them. A California workers’ compensation lawyer at Sargent Law Firm can evaluate your situation and ensure that your injuries are accurately classified, documented, and compensated per California law.
Is it legal for my employer to fire me for filing a workers’ comp claim in California?
No, California law strictly prohibits retaliation against employees who file a workers’ compensation claim. If your employer demotes, fires, or discriminates against you for seeking benefits, you may be entitled to additional compensation and legal remedies under Labor Code §132a. The workers’ compensation attorneys at Sargent Law Firm can file a retaliation claim and pursue penalties on your behalf while also protecting your ongoing workers’ comp benefits. If you suspect unfair treatment, you should speak to a California workers’ compensation lawyer immediately.
How long can I receive workers’ compensation benefits in California?
Temporary disability benefits in California are typically available for up to 104 weeks within a five-year window from your injury date. Permanent disability benefits, if applicable, can extend beyond that depending on the severity and long-term impact of your injury. Some workers may also be eligible for a Supplemental Job Dislocation Benefit to retrain for an alternative occupation. A California workers’ compensation lawyer from Sargent Law Firm can calculate your full benefit eligibility and make sure your benefits are not wrongfully cut off or delayed.
What should I do if my workers’ compensation claim is denied in California?
If your claim is denied, you still have legal options. You must file an “Application for Adjudication of Claim” with the Division of Workers’ Compensation (DWC) to request a hearing before a workers’ comp judge. The workers’ compensation attorneys at Sargent Law Firm can handle every step of the appeals process, from gathering additional medical evidence to presenting your case at the district office. Denials often stem from technical errors or weak documentation, so having an experienced California workers’ compensation lawyer in your corner significantly improves your chances of a successful appeal.
