Who Are All The Liable Parties In A Workers’ Compensation Case?

In a workers’ compensation case, the liable party is the workers’ compensation insurance company. The employer has bought a policy of workers’ compensation insurance, so they are not directly responsible to pay benefits to the injured worker.

How Long Does The Worker Have To File A Workers’ Compensation Claim?

An injured worker has one year from the date of knowledge of the injury to file the claim with a Workers’ Compensation Appeals Board (WCAB). An injured worker should report the injury immediately after the injury occurs to their supervisor, boss, or human resource person. If reporting verbally, a follow up text or email message to the supervisor, boss or HR person is a great way to protect your rights. In many cases, we see that employers deny a verbal report of injury was ever made and this can be the reason the case is denied.

What Happens After I report my Work Injury?

The law requires an employer to provide the workers compensation claim form (DWC-1 claim form) within one working day of the employee’s reporting an injury. The DWC-1 claim form provides written documentation that an injured has been claimed. This form must be provided by the employer to the employee claiming injury, whether they admit the injury or not. The employee must complete the employee section and give the form back to the employer who then has a legal obligation to send it to the workers compensation insurance company so a claim can be opened for you. Usually within about a week or two after you report your work injury you should receive a letter and packet of information from the workers compensation insurance company. By the time you receive this packet you should have obtained an initial consultation from an experienced workers compensation attorney to learn your rights as well as do’s and don’ts to protect those rights.

How Do I Know If Have A Valid Workers’ Compensation Claim?

Oftentimes, it’s difficult to know if you have sustained an injury at work, especially if the injury is cumulative in nature, such as mild low back pain or mild numbness in the wrists or lower extremities which is occurring over time. It’s important, if you have any symptoms or pains in your body, to seek a doctor’s opinion on the issue of whether there is any relation to the work activities you are performing. You have two options. You can visit your private doctor (not work comp insurance) for an evaluation of symptoms and tell the doctor you believe the symptoms may be work related and ask the doctor if he or she agrees. Whether the doctor agrees or not, call an attorney right away because even the doctors may miss the diagnosis or not take the time to get a good work history to connect the symptoms with the work activity. The second option is to report the symptoms as work related to your employer such as “I have symptoms in my low back and the pain goes down my right leg. I think the symptoms may be work related. Please provide me a work comp claim form and send me to our work injury clinic for a checkup”

Does A Worker Have to Be Injured At The Physical Place Of Employment To Qualify For Workers’ Compensation?

You don’t have to be injured at the physical place of employment to qualify. As long as you are on the clock during your injury, it doesn’t matter where the injury occurs. Traveling salesmen would be a good example of people who often get hurt out on the road. Those injuries are covered because they are on the clock. We once represented a nice woman whose injury occurred from sitting more than 9 hours on a flight to Europe. The injury was a blood clot which caused her to be 100% Permanently Totally Disabled, a very big case indeed!

Are Repetitive Stress or repetitive motion Injuries More Difficult To Prove In A Workers Comp Case?

Repetitive trauma injuries are often initially delayed and then denied but there is no reason to give up. They are just as easily proven with a good medical history among other things. We pay attention to the details regarding the type of work our client is performing and how long they’ve been doing that work, and we make sure the doctor understands this as well.

How Important Is Your Past Medical History In a Workers’ Comp Case?

The medical history is very important and you should always disclose all prior injuries and health conditions to each doctor seen. An attorney can deal with negative information but it is very difficult to overcome the claim that someone has intentionally left something out in an effort to deceive.

What Is The Workers’ Compensation Process In California?

First, the injury is reported to the employer. Within one working day, the employee is given a workers’ compensation claim form (DWC-1 claim form) to complete and return to employer. Then, the employer sends the employee to the industrial medical clinic for an assessment. Within a week or so of the employer sending the completed claim form to the workers’ compensation insurance company, the employee receives a packet of information from the insurance company. All dealings with the clinic now are directed to the claims adjuster assigned and the employer no longer is involved in the case generally.

The workers’ compensation insurance company can accept the injury claim or delay a liability decision for up to 90 days, or deny the claim altogether. By the time you receive the initial claims packet, you should already have consulted with an attorney, so you know what to expect. There are many ways the claim could go from that point. The most important thing to remember is that a denial of the claim does not end the case nor does it mean you will get any less benefits than a claim that is “admitted”.

How Is The Amount Of My Workers’ Compensation Claim Determined?

The amount of your workers’ compensation settlement is based on two things. The first is the percentage of permanent disability you have. The second is the estimated amount of future medical care you will need. In workers’ compensation, there is no payment for pain and suffering and you do not get your full wage losses.

For more information on Liable Parties In A Workers’ Comp Claim, a free initial consultation is your best step. Get the information and legal answers you are seeking by calling 714-942-4655 today.