A recent California case involving a painter seeking workers’ compensation benefits after an employer attempted to deny their claim highlights some of the nuances these cases can involve when employers wish to deny benefits to employees eligible to receive them.
The case, Menchaca vs. Hedman Manufacturing Company, involves a painter for a manufacturing firm who sought workers’ compensation benefits after developing injuries to his neck, knees, back, shoulders, and other body parts during his employment. The claimant argued that his injuries were work-related because his job frequently required lifting items as heavy as 70 pounds.
His employer initially denied his application for workers’ compensation benefits. They stated that the claimant had failed to provide substantial evidence of work-related injuries.
The claimant’s doctor disagreed. Their primary treating physician determined one could reasonably assume the nature of the claimant’s work was the main factor contributing to the injuries they’d sustained. A panel-qualified medical evaluator echoed this opinion.
At first, a workers’ compensation administrative law judge ruled that the claimant was entitled to no benefits. Their justification was that he hadn’t sustained an injury from or during his employment. In response, the claimant asked for reconsideration. Reconsideration was granted, and the Workers’ Compensation Appeals Board of California panel rescinded the original ruling.
One of the reasons the workers’ compensation administrative law judge ruled against the claimant was that his stories were inconsistent. For example, he sometimes changed his story when describing the weight of the heaviest object he had to lift or when citing the year his knee pain first developed.
It was determined that these inconsistencies were minor compared to the opinions of the qualified medical evaluator and the applicant’s primary doctor. Because both agreed that the applicant likely could have developed these types of cumulative injuries due to his employment, the Workers’ Compensation Appeals Board of California decided there was sufficient medical evidence to indicate the claimant was eligible for the workers’ compensation benefits he sought.
Cases such as this one serve as a clear reminder that receiving workers’ compensation benefits isn’t necessarily as easy as simply filing a claim. For various reasons, employers and insurance companies are often reluctant to pay applicants what they deserve. They may be more inclined to deny claims to protect themselves financially.
This doesn’t mean you should expect to face an uphill battle if you ever need to file a workers’ compensation claim in California. Instead, you should consider enlisting the help of an expert who can provide you with the representation you need in these circumstances.
At the Law Offices of Kropach & Kropach, we’re dedicated to helping injured and ill workers throughout Los Angeles and the surrounding areas secure the workers’ compensation benefits to which they’re entitled. Learn more about what our LA workers’ compensation attorneys can do for you by contacting us online or at 818-609-7005.
