Los Angeles Medical Benefits Attorney

If you or a loved one are injured at work, you should be able to count on workers’ compensation insurance to cover your expenses. However, we know that you may need a Los Angeles medical benefits attorney to help. Far too often, injured workers are denied their claims after a workplace injury.

At the Law Offices of Kropach & Kropach, our qualified and experienced Los Angeles medical benefits lawyer team is going to get to work on your behalf so we can secure the compensation you deserve.

What Can Happen After A Work Injury?

Workplace injuries and illnesses are not uncommon. In fact, the Bureau of Labor Statistics tells us that there were more than 2.8 million nonfatal workplace injuries or illnesses reported during the latest reporting year.

Unfortunately, many workers may find that they are not prepared financially to deal with the impact of missing their full wage and that is made worse if they face medical costs. Consider the following workplace injuries and illnesses we deal with regularly:

  • Spine and Spinal Cord Injuries
  • Traumatic Brain Injuries
  • Broken or Dislocated Bones; Traumatic Crush and Fracture Injuries
  • Spinal Fusions
  • Joint Replacements
  • Hearing and Vision Loss
  • Cardiovascular disease requiring surgery; heart attacks
  • Chronic Respiratory / Pulmonary Disease / Insufficiency
  • Strokes
  • Severe lacerations or amputations
  • Even cancer and other insidious progressive diseases/illnesses

Workers’ compensation insurance is supposed to provide benefits for most workers. However, we know that the insurance companies regularly deny claims or do not offer enough compensation for all of the medical expenses.

Why Would A Claim Be Denied?

There are deadlines that need to be met in order to be eligible for workers compensation benefits. In California, the injured worker should report their injury within 30 days from their date of knowledge. However it is worth mentioning that under Labor Code Section 5402 if the employer was aware of any kind of information or received sufficient information regarding injury to afford the employer the opportunity to make an investigation into the facts – that is the equivalent of providing notice within 30 days; also under Labor Code Section 5403, injured workers’ will not be barred for failing to report the claim to the employer within 30 days of the injury unless the employer can show that the delay substantially prejudiced their ability to defend the claim: the absence-of filing a claim within 30 days is rarely successful but it does open the door for the insurance carrier argue and attempt to deny an otherwise legitimate injury.

More importantly, you must file your claim with workers’ compensation within one year if the insurance company has not provided any benefits, though you have five years if they provided some benefits.

If you had preexisting conditions that could have caused your injury, your claim might be denied. A skilled workers’ compensation attorney can help you establish that you have suffered a work-related injury despite having a pre-existing medical condition. You should also know that an injury that happens off of the worksite or while commuting to or from work may be denied unless you were conducting work-related business.

Workers Suffering Pre-Existing Conditions are Entitled to Medical Benefits

California workers’ compensation law can cover employees who have pre-existing conditions. If the judge finds that work activities have caused no increase in symptoms or injury then obviously there would be no benefits for the injured worker. But if a preexisting condition – like an underlying sports injury, arthritic conditions, a herniated spinal disc, or pregnancy-related carpal tunnel or back pain– is made worse due to work activities then the employer’s insurance carrier is liable for the portion of the injured workers’ injury that is work-related. Although the insurance carrier is not liable for the permanent disability that is directly attributable to a pre-existing injury, they should still be liable for the permanent disability that is directly attributable to work activities and they would be liable for unapportioned temporary disability and medical care.

According to law, injuries must occur “in the course of employment” for employees to secure workers’ compensation benefits. In many claims the insurance carrier or their attorney may doubt that the work activities caused the injured workers’ injury – they may claim that the injury is purely genetic, hereditary, or preexisting.

A workers’ compensation insurance company may initially deny claims for work-related injuries that aggravated a pre-existing condition. A workers’ compensation attorney can assist you in presenting the best argument to show a judge how work caused a need for medical treatment, temporary or permanent disability benefits.

California Workers’ Compensation Medical Benefits and the Going-and-Coming Rule

The law holds that workers’ compensation, including medical benefits, are available to those employees injured in the course and scope of employment. To be eligible for benefits and other compensation, the employee must show that they suffered harm while performing occupational duties. The going and coming rule generally precludes awards of benefits to those employees traveling to work, as they are not engaged in work-related tasks. However, there are exceptions to this rule. If an employee is traveling from one work site to another for the purpose of employer-encouraged tasks, they may be eligible for benefits. Additionally, if travel time is considered part of the working day by contract, the employee will likely be considered engaged in work-related tasks. Other exceptions may include:

  • Work trips: A worker that travels for their job may be exempt from the going-and-coming rule. Taking a work trip to the airport may include driving to the hotel, flying, and returning by car to the airport. All legs of this trip will likely be covered by workers’ compensation as an exception to the going-and-coming rule.
  • Driving is part of work-related tasks: Workers who operate a vehicle for their job, such as delivery drivers, postal workers, and transit workers may not be subject to the going and coming rule. If these employees suffer harm while performing their job, they will not be subject to the going-and-coming rule.
  • Work-related errands: Employees tasked with “special jobs,” including errands for their employers, may be eligible for workers’ compensation benefits if injured during the completion of this task. Despite the fact that the injury may have occurred after working hours, the mission was a part of the business and the employee is entitled to benefits.

Insurance companies may nevertheless try to deny claims for workers’ compensation. By engaging a dedicated Los Angeles medical benefits lawyer, you are taking the first step toward ensuring you receive the benefits you deserve.

Speak to a Los Angeles Workers’ Compensation Medical Benefits Attorney Regarding Your Injury

If you or someone you love has been injured at work and is struggling to get the medical benefits needed, please seek legal assistance as soon as possible. At the Law Offices of Kropach & Kropach, we are ready to get to work on your behalf. Let our Los Angeles medical benefits lawyer investigate what happened so we can secure the compensation you deserve. This can include:

  • Coverage of medical expenses (current and future)
  • Recovery of lost wages if you are unable to work
  • Pain and suffering damages
  • Loss of enjoyment of life damages

If you need a Los Angeles medical benefits attorney, you can contact us for a free consultation by clicking here or calling us at 818-609-7005.

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