Workers’ Compensation: What You Need to Know
Workers’ compensation is like a safety net for employees who get hurt at work or become sick because of work conditions. Employers pay an annual insurance fee to an insurance company, and if something happens to an employee, the worker can get benefits like medical care and lost wages by filing a claim with the insurance company.
Who Can Get Workers’ Compensation?
If you got injured or got sick because of your job, you might qualify for workers’ compensation benefits. It doesn’t matter whose fault it is. In most cases, you can’t sue your employer for damages if you get workers’ comp benefits. Instead, the Workers’ Compensation Appeals Board (WCAB) deals with these benefits.
Who Needs Workers’ Compensation Insurance?
All employers in California with at least one employee must have workers’ comp insurance. They can get it from an insurance company or sometimes large employer insure themselves.
How to File a Claim?
Your employer should tell you how to file a workers’ comp claim with the workers’ compensation administrator. Make sure to follow the deadlines to protect your claims. You can fill out the employee section of the WORKERS’ COMPENSATION CLAIM FORM (DWC 1) and give it to your employer. They must fill out their part and give copies to their workers compensation claims company and you within one business day. You can also get help from a workers’ compensation attorney.
When Do You Need a Work Injury Lawyer?
If your injury is minor and you didn’t miss much work, you might not need a lawyer. But in some cases, a lawyer can help, like if your employer denies the claim, doesn’t give you treatment, or if you believe your injury will likely affect your work or life a lot. A lawyer can also help if you have questions about other benefits or if your employer mistreats you for filing a claim.
The Next Step
To make sure you get all the benefits you deserve, it’s best to talk to a workers’ comp lawyer. You can contact attorney Thomas F. Martin for a free and private consultation by calling 714-547-5025 or reaching out online. Learn more about workers’ compensation by clicking this link.
Meet Thomas F. Martin: The Workers’ Comp Lawyer!
Thomas F. Martin, PLC is a highly respected Workers’ Compensation Attorney, honored by various organizations for his outstanding work over the years.
He has been recognized as one of the “Best Attorneys” by esteemed publications like The Orange County Register, The Los Angeles Times, Los Angeles Magazine, and Orange Coast Magazine. Additionally, many professional organizations have acknowledged his experience in work injury law.
Mr. Martin’s dedication extends beyond his legal practice. He has served as the President of the Orange County Chapter of the California Applicants’ Attorneys Association, and he has been involved in various committees and the Board of Directors for various organizations.
His knowledge in the workers’ compensation field is valued, and he is often invited to speak at events, sharing insights on the latest laws and trends, and even training other lawyers.
If you need help with a work injury claim in Orange County, choosing a skilled attorney like Thomas F. Martin is crucial to ensure you receive all the benefits you deserve. Call 714-547-5025 or contact us online to schedule a free and private consultation.
Workers’ Compensation Penalties For Delayed Payments (Labor Code 5814)
As an injured worker, understanding the various labor codes that govern your rights and protections in the workplace is essential. When claims administrators are late paying workers’ compensation benefits, California Labor Code 5814 can increase the benefit to the injured worker up to 25% up to certain maximums.
What is Labor Code 5814?
Labor Code 5814 is a section of the California Workers’ Compensation Law that outlines the penalties for employers who are overdue in paying medical and indemnity benefits owed to an injured worker.
Specifically, this section states that if a claims adjuster fails to timely provide workers’ compensation benefits in the form of payments for medical bills, or payments to an injured employee, they will be subject up to a 25% penalty on the amount of benefits that were not paid up to a certain maximum. This penalty is paid to the injured worker and IN ADDITION to any other penalties or fines that may be imposed by the state against the claims administrator.
Understanding the penalties for violating Labor Code 5814
The penalty is intended to deter claims administrators from delaying the payment of benefits to the injured workers that are owed. Some penalties are automatically owed if not paid promptly.
How to avoid violating Labor Code 5814
It’s simple: the best way for a claims administrator to avoid violating Labor Code 5814 is to ensure that they are fully compliant with workers’ compensation laws and pay the benefits owed to the injured worker and the physicians on time.
Steps to take if you believe your employer has violated Labor Code 5814
SAVE THE ENVELOPE!
The best way to prove that a payment to an injured worker was paid late is to save the envelope the late payment came in so it can be provided to the Workers Compensation Judge (WCJ) at the appropriate time.
SAVE LETTERS AND EMAILS
Any documentation you have related to the late payment should be saved as well.
KEEP ANY DEMANDS FROM DOCTORS
If you receive any notices of overdue bills from any of the doctors involved in your workers’ compensation claim, do not throw them away! Even if the workers’ compensation carrier may eventually pay the doctors, a penalty may still be owed to YOU.
DEMAND A BENEFIT PRINTOUT
You are entitled to see what payments the claims administrator has made and when. Keep a copy of any letter or email you send to the claims administrator demanding a printout of all payments made to you and medical providers.
Hiring a workers’ compensation attorney to help with Labor Code 5814 issues
If you believe that the claims administrator has delayed payments in your case, consider contacting an experienced workers’ compensation attorney. An attorney can help you understand your rights and options, gather evidence to support your claim and navigate the complex legal process involved in pursuing the penalties you may be owed. Contact Thomas F Martin PLC at 714-547-5025.
Thomas F. Martin, PLC Receives “Lawyer of the Year” Award From Best Lawyers®
Thomas F. Martin, PLC, a leading workers’ compensation attorney in Orange County, CA, has been recognized by his peers as the 2023 “Lawyer of the Year” in Workers’ Compensation Law – Claimants in Orange County. In addition, Martin will be highlighted in the 29th edition of The Best Lawyers in America® for his expert contributions to Workers’ Compensation Law – Claimants.
Every year, more than 12.2 million evaluations are submitted by top attorneys across the country. The transparent methodology is based on the fact that the best attorneys know who the best lawyers are. As a result, only the top 0.4% of lawyers earn the exceptional distinction of “Lawyer of the Year.”
According to the directory, “For more than 40 years, Best Lawyers has been regarded—by both the profession and the public—as the most credible measure of legal integrity and distinction in the United States. As such, recognition by Best Lawyers symbolizes excellence in practice.”
The directory does not charge a fee or payment to participate in the voting process, ensuring accessibility and trustworthiness. Winners of this year’s awards are eligible to participate in the exclusive voting process for next year’s edition.
Speaking of the recognition, Thomas Martin said, “It’s an honor to once again be named ‘Lawyer of the Year” by Best Lawyers. I believe injured workers deserve the highest quality of legal representation and it has been my commitment to serve them for more than 25 years.” He adds, “Justice is not easily achieved, but it’s worth the fight!”
Martin represents injured workers who have sustained chronic and career-ending injuries, and even the families of workers killed in a workplace accident. He has chosen to specialize in Workers’ Compensation to ensure clients receive expert representation.
To learn more about Thomas F. Martin, PLC, visit https://www.thomasfmartin.com/about/
What to Expect From a Psychiatric Workers’ Comp Claim in CA
When we think of workers’ comp injuries, we generally think of physical injuries like broken bones, tissue damage, burns, and lacerations. But workers’ compensation also includes psychiatric injury, which is a mental disorder determined to be at least 50% caused by the workplace.
How to claim a psychiatric injury.
To obtain compensation for a psychiatric injury, an employee must:
- Show employment for six months or longer
- Prove that work activities or the work environment were greater than 50% of the cause of psychiatric injury
- Prove the injury was not a consequence of physical injury
If the psychiatric injury was caused by a violent act, then the employee must show that 35-40% was caused by work. In addition, the six-month requirement doesn’t apply to injuries caused by a sudden and extraordinary event.
Can physical and psychological injuries be combined in a claim?
A psychological injury cannot be caused by a physical work injury. An injured employee can only add a psychological claim to the original injury if it was due to a violent crime or a catastrophic injury such as paralysis, severe burn, amputation, or severe head injury.
What is the difference between an injury and a permanent disability?
If the worker has not sustained a psychiatric work injury, then they will not receive any medical treatment, temporary disability, or permanent disability. If a physician does identify a psychiatric injury in a worker, then the extent of disability and evaluation of non-work-related factors will be determined on a separate basis.
How a psychiatric claim is rated in CA workers’ comp.
In California, a psychiatric work injury is rated using the Global Assessment of Function (GAF) scale, which is then converted to a percentage and adjusted up or down using the Permanent Disability Rating Scale (PDRS). A GAF rating below 70 is considered a permanent disability.
What to expect during a psychiatric injury claims process.
To determine a worker’s eligibility for compensation, the insurance company will ask questions about the workers’ relationship with friends and family, medical conditions, sex life, past abuse, and trauma. An injured worker should decide if filing a psychiatric claim is worth answering questions on such personal matters.
What Every California Employee Needs to Know About Workers’ Comp
While the workplace has become safer over the past few decades, and worker injury rates have decreased, obviously injuries still occur on a daily basis.
The workers’ compensation system is complex, and a work injury lawyer in Orange County can be of assistance in navigating the California workers’ compensation system. Almost like your “tour guide” through the system.
Here are some general answers to common questions:
1. What is workers’ compensation?
Workers’ compensation is a form of protection for employees that employers must have to pay for workers that are injured on the job. Wage replacement benefits are provided as well as medical treatment at not cost to the injured employee.
2. What should I do if I’m injured at work?
A Worker who gets injured at work or sustains a work-related illness should tell their supervisor as soon as possible and fill out a claim form. Prompt reporting will help the worker gets the medical care and benefits they deserve. The employer should investigate the accident and immediately file your claim with their insurance company. Once the employer receives the completed claim form from the employee, they are required to fill out their portion of the form. Workers who need medical treatment should get it immediately.
3. Do I need to fill out the DWC 1 claim form?
Workers generally must complete the DWC 1 claim form to start the process of obtaining benefits. Otherwise, the employer may later say they didn’t know about the injury or illness you reported.
4. What kinds of benefits am I eligible for?
After reporting a work injury, a worker may be eligible for the following immediate benefits:
· Up to $10,000 in treatment while the claims administrator investigates the claim.
· Wage replacement benefits if a physician determines that injury prevents working, or the employer refuses to honor your work restrictions.
If the claim is accepted, injured workers may qualify for the following benefits:
· Continuing medical treatment
· Temporary disability benefits
· Permanent disability benefits
· Future medical care
· Supplemental job displacement benefits
· Other benefits required by law
5. Do I need a workers’ comp lawyer?
Injured workers should consider obtaining a free consultation with an Orange County workers’ compensation lawyer if:
· The physician assigned to the case is not providing appropriate treatment
· Treatment is being denied by the insurance company
· The employer or insurance carrier denies the accident or injury is work-related
· The employer doesn’t file the necessary paperwork on time
· It appears there will be permanent disability
· The settlement doesn’t cover all lost wages and medical bills
· They have a preexisting condition the insurance company is using as an excuse not to pay benefits
· They plan to file for Social Security disability benefits
· The employer retaliates against the injured worker even though the injury or illness is work-related
· Another person or company may be responsible for the injury
Your rights can be lost if a claim is not pursued promptly. Delays in making a claim may result in the statute of limitations barring the claim forever. Act promptly.
Common Challenges In Workers’ Comp Cases
When it comes to work injury claims, challenges are to be expected. Insurance companies don’t want to pay benefits and use many techniques to avoid paying them. Fortunately, experienced lawyers like Thomas F. Martin know how to navigate through those challenges and reach a positive outcome for their clients.
If you have a work injury, here are a few potential challenges a work injury lawyer in Orange County might help you with:
- Benefit delays
Disability benefits are often delayed at the beginning of a case. However, n injured workers’ bills don’t stop just because a worker is injured on the job. If you are taken off of word due to an injury, and the insurance company is not paying you temporary disability benefits, you may need to consult with a lawyer to find out your options. Sometimes a hearing before a workers’ compensation Judge is necessary. Penalties may be owed to you as well. An Orange County workers’ compensation attorney can assist you in resolving benefit payment delays.
- Difficulty obtaining medical treatment
Insurance companies usually insist on you treating with the doctor they assigned to you. Often, these doctors will be told by the insurance company that they can only treat you for the injuries that the insurance company “admits” were injured, and the rest of the injuries are ignored. For example, if you are seriously injured in a fall, and as a consequence of the extreme pain and sleeplessness you lose control of your diabetes, the insurance company is responsible for not only treating your work injuries but also getting your diabetes back under control. But often, the insurance company adjuster will refuse to pay for the treatment for diabetes because it was “pre-existing”. That’s the type of situation you may want to consult with an Orange County worker’s compensation attorney about to determine your rights and options.
- Employer retaliation after filing a claim
After a worker reports a work injury, employers may come up with all kinds of excuses to criticize a worker for “performance issues” like “working too slow”, or “not following the rules”. If it is determined that the employer is discriminating against the injured worker because of the report of a work injury, the employer may be violating the law, and additional benefits may be owed. An Orange County workers’ compensation attorney will know what kind of evidence is necessary to prove retaliation and obtain the benefits you may be owed.
- Disputes over preexisting injuries or conditions
One of the most common methods insurance companies use to reduce or deny workers’ compensation benefits is to blame a PAST condition or injury for the CURRENT disability the injured worker is experiencing. Even if the workers’ PAST injury or condition has fully recovered a long time ago, the insurance company will argue that the PAST injury is the reason for the current health challenges of the worker. If you are facing this type of challenge to your claim, an attorney can assist you in pushing back on this insurance company tactic.
- Disputing that you are an employee
Some employers, even rideshare and food delivery companies, create the impression that their employees are “independent contractors” so they can avoid paying for worker’s compensation benefits. However, the law in California requires that companies follow certain guidelines before a worker can be considered an “independent contractor”. If you have suffered an injury while you were working, and the company or its insurance company is denying you workers’ compensation benefits, you should consider consulting with an Orange County workers’ compensation lawyer to determine whether you were an independent contractor or employee.
Tesla Ordered To Pay $137 Million To Former Worker
Owen Diaz, a former Tesla employee who worked as an elevator operator at the company’s Fremont factory for nine months from 2015 to 2016, was recently awarded a $137 million settlement as compensation for the racial abuse he experienced during his tenure.
He was called racial epithets by coworkers, told to “go back to Africa”, and saw racist graffiti in the bathrooms. The jury found that Tesla had not taken reasonable steps to prevent racial harassment in the workplace.
The company’s lawyers stated the factory employed approximately 10,000 workers, many of whom were contractors hired through external staffing agencies. And so, they argued, there was no evidence that Tesla employees were directly responsible for the racial harassment.
Diaz’s attorneys brought three claims against Tesla:
1. The company subjected him to a racially hostile environment.
2. The company failed to provide a harassment-free workplace.
3. Tesla was negligent in its supervision of employees.
The jury sided with the plaintiff on all claims and ordered Tesla to pay Diaz $6.9 million in compensatory damages and $130 million in punitive damages — far above what his attorneys requested.
The eight jurors deliberated for four hours before reaching a decision.
Though Tesla has a practice of mandatory arbitration, the company’s reliance on contractors opened the door for the lawsuit. Because Diaz was a contractor himself, he never signed the company’s arbitration agreement and became the first worker to file a lawsuit against Tesla that went to a jury trial.
Tesla’s “Vice President of People” Valeria Capers Workman said, “The Tesla of 2015 and 2016 (when Mr. Diaz worked in the Fremont factory) is not the same as the Tesla of today.” She added, “We acknowledge that we still have work to do to ensure that every employee feels that they can bring their whole self to work at Tesla.”
The company has not said whether it plans to appeal the verdict. Tesla is facing a similar lawsuit in California state court from Marcus Vaughn and others, who allege Tesla created a hostile workplace for Black workers.
Best Workers Compensation Lawyer Ranking!
The 2021 U.S. News “Best Law Firms” publication will include our own Tom Martin in its 11th annual Edition. (more…)
Thomas F. Martin Recognized by Orange Coast Magazine as Top Attorney in Orange County
If you are facing a criminal charge, no matter how minor, you should talk to a defense attorney to fully understand your case. A consultation with an experienced attorney will help you to understand the charges placed against you, the defenses available, what if any plea bargains may be offered to you, and what you should do if you are convicted.