Los Angeles Workers Compensation Attorney

Nearly every employee in California is protected through the worker’s compensation system. Workers’ compensation is a compromise between employees and employers: workers’ compensation benefits are reduced, as compared to a personal injury claim, but benefits are provided without a determination of whether the employer or employee was negligent. However, liability is not automatic and workers’ compensation claims are often denied in their entirely or partially. Unfortunately, some workers’ compensation insurers delay or deny legitimate claims unnecessarily. At the Law Offices of Kropach & Kropach, we are here to help if you need a Los Angeles workers compensation attorney by your side. Let us investigate your claim and help secure full compensation for your losses.

Eligibility for Benefits According to California Workers’ Compensation Law

As a no-fault system, employers provide workers’ compensation benefits to injured employees when the employer has not caused the underlying harm. The benefit to the employer is that they are shielded from liability in a personal injury lawsuit. However, employees seeking workers’ compensation must satisfy certain requirements in order to be eligible for benefits. In addition to meeting deadlines and following procedures set by California law, employees must demonstrate their injury or illness arose out of and in the course of their employment.

The work-related requirement for an eligible workers’ compensation claim may be apparent in many cases. A worker is clearly injured on the job when scaffolding crushes their limbs and there are multiple witnesses attesting to the accident. Certain illnesses and injuries may not be as apparent and the insurance carrier may be more likely to deny the claim.

Some insurance carriers are reluctant to admit liability when a work injury aggravated a pre-existing condition, or if there is a wear and tear / cumulative injury – they may want to point the finger at a different employer; insurance carriers are often more hesitant to admit liability for psychological injury claims — by law psychological injury claims require a higher threshold of proof than any other kind of work injury. A skilled job injury lawyer can advocate on your behalf and formulate the arguments that best assist in getting your workers’ compensation claim approved by the judge or insurance company.

What is Covered Under California Workers Compensation?

The California worker’s compensation system provides fairly adequate resources for those who sustain on-the-job injuries. This includes the following:

  • Medical expenses: Including coverage of emergency medical bills, as well as ongoing treatment necessary to help the injured worker reach their maximum possible medical improvement. If a doctor and or a judge finds that the injured worker has reached their maximum medical improvement – the injured worker will likely still be entitled to future medical care that is reasonable to relieve, or cure, the injured worker.
  • Travel reimbursement: This will include any cost of travel to and from medical visits, therapy, and pharmacies — during the recovery process.
  • Lost wages: While the injured worker is healing from their injury, temporary disability payments can be paid — these typically amount to two-thirds of the injured worker’s weekly pay at the time the injury occurred.
  • Temporary or Permanent Disability Benefits: As stated above, temporary disability is paid during the healing period – except for a few exceptions temporary disability is capped at no more than 104 weeks of payment. When temporary disability ends, workers may be entitled to permanent disability benefits, these benefits calculated after referring to medical records, work history, and the age of the injured worker.
  • Return to work assistance: If the injured worker is not able to return to work after they have had time to heal from their injury then they may be entitled to supplemental workers’ compensation benefits / vocational rehabilitation benefits: to assist them in trying to return to work or start a new career.

Time Limit to File a Workers Compensation Claim in Los Angeles

We strongly encourage any person who has sustained a workplace injury or illness to report the incident as soon as possible.

Labor Code Section 5400 contains language that seems to set a 30-day time limit to inform the employer of a work injury, however, Labor Code Sections 5402 and 5403 effectively remove that time limit. Under Labor Code Section 5402, provides that 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 is the equivalent of Labor Code Section 5400 notice. And 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-notice defense is rarely successful.

More importantly: a worker must start their claim with the Workers’ Compensation Appeals Board within one year from either: (i) the date of injury; (ii) the last day they received monetary workers’ compensation benefits; (iii) the last day they received medical workers’ compensation benefits.

It is not practical to go over all the nuances on how late an employee can file a workers’ compensation claim in this article: it is hard to imagine a situation where it would not be in the employee’s best interest to file a claim as soon as they are aware of their workers’ compensation injury, but if for some reason an injured worker was not able to timely file their workers’ compensation claim or notify their employer — perhaps the injury developed slowly over time or manifested after employment ended — then there may be an exception that allows the injured worker to maintain a claim for workers’ compensation benefits.

Filing deadlines are different for serious illness, or other injuries that may not be readily apparent. Certain diseases require medical diagnosis over time, and their work-related cause may not be immediately obvious. Deadlines for an occupational illness that occurred over time may have a different timeframe than injuries endured in a one-time accident. For example, the time period may center upon the discovery of harm, or when you should have discovered your harm resulting from your job. It may also include the date of your last exposure to the source of harm at work. A dedicated Los Angeles workers’ compensation attorney can help you meet deadlines in order to properly file your claim for benefits.

Securing Medical Treatment for Workers’ Compensation Injuries or Illness

It is important to seek medical treatment as soon as possible after suffering a workplace accident or developing symptoms of an occupational illness. Doctors will review your injury, and in assessing your condition, begin the process of documenting your harm. This documentation is important in the event that employers and insurance companies contend your condition is not job-related.

The workers’ compensation system sets forth rules for non-emergency medical care. In order to maximize your benefits, it is important to abide by the procedures and mandates regarding your treatment. Workers’ compensation medical insurance is governed by numerous rules, procedures – doctors, injured workers, and insurance carriers can make procedural mistakes that can result in delays to the injured worker or possible penalties against the insurance carrier. An attorney skilled in job injury claims can help you make sure that the insurance carrier is timely and properly responding to your doctors’ request for treatment and if a recommended treatment is denied – the attorney can appeal the denial and seek reversal through independent medical review. The attorney can help guide you through the process on how and why treatment gets denied and what evidence is needed to get the treatment approved.

What About Third-Party Lawsuits?

If the workplace injury or illness was caused by a party other than the employer or a coworker, the injury victim may be able to file their personal injury lawsuit in an attempt to recover compensation for their losses. Some of the most common third parties in these cases include subcontractors working around the employee or various product manufacturers who may have supplied defective parts to the employer.

Third-party lawsuits must be filed within two years from the date the injury occurs. This is in line with the California personal injury statute of limitations.

Damages Available in a Third Party Claim as an Injured Worker

One benefit to filing a third-party claim for damages is that injured workers may receive different forms of compensation than they would in a successful workers’ compensation claim. Workers’ compensation benefits typically provide for medical costs, a percentage of wages missed from work due to injuries — on a temporary basis, and vocational rehabilitation. By filing a personal injury claim against a third party, an injured worker can potentially recover monetary damages for a wider range of harm. As compensatory damages, these are intended to place the injured worker in the position they would be, had the accident not occurred. Personal Injury compensation may include:

  • 100% lost wage replacement
  • Reimbursement for calculated decreased future earning capacity;
  • Emotional pain and suffering;
  • Property damage, if applicable; and
  • Medical benefits
  • Punitive damages.

Unlike in workers’ compensation: personal injury claims have the chance to go before a jury – the jury can hear your claim and may award you benefits beyond the caps of workers’ compensation claims, including the pain and suffering from the effects of the injury and the potential for punitive damages when the defendant’s conduct demonstrates intent or maliciousness. These types of damages are intended to deter similar conduct. In general, the cumulative effect of a third-party damages award is that payments can be much larger than a workers’ compensation award.

Reach out to a Los Angeles Workers’ Compensation Attorney Regarding Your Claim

If you or somebody you care about has sustained a workplace injury but is having trouble securing workers’ compensation benefits, the Los Angeles workers compensation lawyer of the Law Offices of Kropach & Kropach is here to help. We have extensive experience handling California worker’s compensation claims, and we know what it takes to secure full benefits for your workplace injury or illness. We will not hesitate to stand up to aggressive insurance carriers or employers to ensure you are treated fairly. When you need a worker’s compensation attorney in Los Angeles, you can contact us for a free consultation by clicking here or calling us at 818-609-7005.

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