What is Workers Compensation?

Workers’ compensation is a form of insurance that provides wage replacement and medical benefits to employees who are injured or become ill while performing their job duties. The purpose of workers’ compensation is to ensure that employees receive necessary medical care and financial support for lost wages without having to sue their employers. It also protects employers from direct lawsuits by injured employees in most cases.

Types of Injuries Covered Under Workers Compensation in California

In California, workers’ compensation covers a wide range of injuries and illnesses that occur in the workplace or are related to work activities, these are:

  1. Traumatic Injuries: These are injuries that occur suddenly and are directly caused by a specific work-related incident. Examples include fractures, sprains, strains, cuts, burns, and injuries from falls.
  2. Repetitive Stress Injuries: These injuries develop over time due to repetitive motions or overuse of certain body parts. Common examples include carpal tunnel syndrome, tendonitis, and bursitis.
  3. Occupational Diseases: These are illnesses or conditions that develop gradually as a result of exposure to workplace hazards, such as chemicals, toxins, or other harmful substances. Examples include lung diseases (e.g., occupational asthma), skin conditions (e.g., dermatitis), and certain types of cancer.
  4. Psychological Injuries: Workers’ compensation in California also covers certain psychological injuries that result from work-related stress, trauma, or harassment. However, there are specific criteria that must be met to qualify for benefits for psychological injuries.
  5. Aggravation of Pre-existing Conditions: If a pre-existing medical condition is aggravated or worsened by work-related activities or incidents, the resulting injury or condition may be covered under workers’ compensation.
  6. Cumulative Trauma Injuries: These injuries result from repetitive stress or strain over time, leading to gradual damage to muscles, tendons, or other tissues. Examples include repetitive motion injuries and cumulative back injuries.
  7. Injuries While Traveling for Work: Injuries that occur while traveling for work purposes, such as driving accidents during work-related trips, may also be covered under workers’ compensation.

How Much Is My Workers’ Compensation Claim Worth?

Each worker’s comp case is different. For temporary benefits, the amount is calculated by two-thirds of the weekly wage before the injury. the minimum and maximum amounts are recalculated each year. Permanent disability benefits are calculated as percentages based on the worker’s age, impairment level, and occupation. A Los Angeles workers compensation attorney is best qualified to guide you through the process of applying for worker’s compensation benefits.

What Benefits Can I Get From Workers’ Compensation In California?

California law requires employers to carry basic worker’s compensation insurance to cover medical care including any hospitalization, doctor’s visits, prescription drugs, lab, and other diagnostic tests, and travel expenses for medical visits. Depending on the case employees may receive temporary or permanent disability benefits and supplemental benefits. In the event of death, the family may receive death benefits to cover medical and funeral expenses.

FAQs Related to Workers’ Compensation in California
FAQs Related to Workers’ Compensation in California

What Are My Rights Under California Workers’ Compensation Laws?

Los Angeles has the same worker’s comp laws as all locations in California. Worker’s compensation is the exclusive remedy to receive compensation for medical expenses or lost wages due to a workplace injury. A Los Angeles workers’ compensation attorney can represent you so you receive the settlement to which you’re entitled.

Why Do I Need QME For My Workers Compensation Claim?

When filing a workers’ compensation claim, it is essential to have a Qualified Medical Evaluator (QME) involved in the process. A QME is a medical professional who specializes in evaluating and determining the extent of a worker’s injury or illness related to their job. They play a crucial role in determining the validity of a workers’ compensation claim and the appropriate compensation that should be provided to the injured worker.

The expertise of a QME ensures that the evaluation process is fair and unbiased, as they are impartial and independent of both the employer and the employee. Additionally, their medical expertise helps to accurately assess the extent of the injury and its impact on the worker’s ability to perform their job. Overall, having a QME involved in a workers’ compensation claim provides a level of expertise and objectivity that is necessary for a fair evaluation and resolution of the claim.

Can I Sue My Employer If They Have Workers’ Compensation Insurance?

In California employers and employees are protected by worker’s compensation laws. Employer liability insurance policies will usually cover legal expenses if a worker blames their employer for a work-related injury or illness. Under California law employers are required to carry worker’s compensation insurance. If an employee is injured on the job and the employer doesn’t have worker’s compensation insurance the penalty could amount to $10,000 per employee at the time the injury occurred.

Can I Sue a Third Party for Additional Money?

Under the California labor code, employers and employees may file a claim of right of action. An employee or family may file for damages that result in the injury or death of an employee caused by a party other than the employer. Worker’s compensation is a no-fault system that allows a worker to collect benefits as long as the injury or illness occurs on the job. A third-party lawsuit may be filed against a party other than the employer. If an injury or illness occurs when a person is at work and the negligence is caused by a third party, you could have a case against the person or persons. A workers comp lawyer can advise you of your rights.

Can I Sue My Employer for Denying My Workers’ Compensation Claim?

A Los Angeles workers’ compensation attorney is the most qualified person to handle your worker’s comp case if your claim is denied. If a worker receives a letter from the claims administrator stating the claim is denied, there are several steps to take. The necessary paperwork that’s filed must be in by a specific deadline. some workers may choose to represent themselves. However, it’s best to have legal representation.

Can I Still Recover Compensation If I’m Being Blamed For an Accident at Work?

California has a no-fault worker’s compensation system. An employer can’t terminate an employee for requesting worker’s compensation benefits. The employee must only prove that the injury or illness occurred at work.

What Are the Most Common Workplace Injuries?

Workplace injuries affect workers in every occupation. The most common injuries that occur on the job are auto-related accidents, injuries while working on construction sites, injuries that result from falling objects, and slip-and-fall accidents.

How Much Time Do I Have to File a Workers’ Compensation Claim in California?

According to California state law, all employees must file a form with the California State Board of Worker’s Compensation within one year. California workers must report their work-related injury to their employer within 30 days of the accident. Failure to report the incident within the allowed time frame could result in being denied worker’s compensation benefits.

What Mistakes Could Compromise My Workers’ Compensation Claim?

  • Failure to act immediately following an accident could compromise a worker’s comp claim. You should document all the details including what you were doing before the injury, how the injury occurred, and what you did immediately following the incident.
  • Report all your symptoms to your doctor including symptoms that change or get worse. You should never embellish your injury or symptoms.
  • Never falsify symptoms or injuries. Doctors will perform an array of diagnostic tests to determine if your claims are legitimate.
  • Never discontinue the treatment plan required by your doctor. You may feel better but symptoms could return or intensify. If you don’t follow your doctor’s instructions the insurance company may assume your injury isn’t as severe as you reported.
  • Insurance companies use the services of private investigators to ensure an employee isn’t engaged in activities beyond their doctor’s restrictions. If you lift a heavy object against the doctor’s instructions, your claim could be denied.

What Should I Do After I Get Hurt On the Job in Los Angeles?

The first thing to do is to report your injury to your employer. If your injury is serious seek immediate medical care. Fill out the worker’s compensation claim form for your employer. You should never attempt to handle your worker’s comp claim yourself. The attorney at Pacific Attorney Group has wide experience in handling worker’s comp cases.

How Much Does it Cost to Hire a Workers’ Compensation Lawyer in Los Angeles?

Your worker’s comp lawyer won’t charge you for handling your claim. The attorney fee is paid out of a portion of the benefits you receive when your claim is settled. Contact Our Los Angeles Workers Compensation Lawyers For a Free Consultation. Call Pacific Attorney Group at 866-803-6502 or submit your case online for a free consultation.

Can I Choose My Own Doctor for the Medical Treatment If I am Injured at Work?

In California, if you are injured at work, you generally have the right to choose your own doctor for medical treatment. This is known as the “personal physician predesignation” rule. However, there are some exceptions to this rule. If your employer has a Medical Provider Network (MPN) in place, you must select a doctor from the network for your initial treatment. The MPN is a group of doctors and healthcare providers that have been approved by your employer’s workers’ compensation insurance carrier. Once you have received treatment from an MPN doctor, you may be able to switch to your own doctor if certain conditions are met. 

What are Some of the Common Mistakes that People Make When Filing a Claim?

When it comes to filing a claim, there are several common mistakes that people often make.

  • One of the most common mistakes is providing incomplete or inaccurate information. It is essential to ensure that all the necessary details are included in the claim form and that they are correct. Any missing or incorrect information can lead to delays or even denial of the claim.
  • Another mistake people make is not gathering sufficient evidence to support their claims. It is crucial to collect all relevant documents, such as receipts, medical records, or photographs, to substantiate the claim. Without proper evidence, it becomes challenging to prove the validity of the claim and receive the deserved compensation.
  • Additionally, failing to file the claim within the specified time frame is also a common mistake. Many insurance policies have strict deadlines for filing claims, and missing these deadlines can result in a complete loss of the claim.

To avoid these mistakes, it is crucial to read and understand the insurance policy terms and conditions thoroughly and seek professional assistance if needed.

If My Workers Compensation Claim is Accepted, How Will My Compensation Benefits be Determined?

If your workers’ compensation claim is accepted, the determination of your compensation benefits will depend on various factors. One of the main factors is the extent of your injury or disability. The severity and nature of your injury will be assessed by medical professionals and used to determine the level of compensation you are entitled to receive.

Additionally, your compensation benefits may also be influenced by your average weekly wage prior to the injury. Generally, workers’ compensation benefits are calculated as a percentage of your pre-injury wages. Other factors that may be considered include the duration of your disability and any limitations it imposes on your ability to work. 

How Long Does It Usually Take For The Insurance Company To Investigate A Workers Compensation Claim?

The duration of an insurance company’s investigation into a workers compensation claim can vary depending on several factors. However, in general, it usually takes several weeks to complete the investigation process. During this time, the insurance company will gather relevant information and evidence, such as medical records, witness statements, and any other documentation related to the claim.

They may also consult with experts or request additional information if needed. Once all the necessary information has been collected, the insurance company will evaluate the claim based on the applicable laws and regulations. It is important to note that each case is unique, and therefore, the time frame for the investigation may differ from one claim to another.

How Long Can I Get Workers Compensation Benefits for My Work Injury Claim?

When it comes to workers compensation benefits for a work injury claim, the length of time you can receive these benefits will depend on several factors. The duration of your benefits will typically be determined by the severity of your injury and the extent to which it affects your ability to work. In general, workers compensation benefits will continue until you have reached maximum medical improvement or until you can return to work.

However, if your injury results in a permanent disability, you may be eligible for long-term benefits. It is important to consult with an experienced workers compensation attorney to understand the specific laws and regulations in your state regarding the duration of benefits for your work injury claim.