When Should You Hire a Workers’ Comp Lawyer?
Just because you’ve sustained an injury on the job doesn’t mean you should rush to hire a workers’ comp lawyer. Some claims are cut and dry and workers will have no trouble receiving the medical benefits and financial compensation they deserve. In other instances, however, injured employees will need the guidance and expertise of a workers’ comp lawyer in Orange County.
The claim is denied
Insurance companies will look for reasons to deny a workers comp claim. They may claim the injury wasn’t work-related or that the worker missed the deadline for filing the claim. Workers may appeal the denial through the state’s workers’ compensation system but would need a lawyer to guide them through the process of filing paperwork, gathering evidence, and presenting the case at a hearing.
The permanent disability rating is disputed
The majority of workers’ comp settlements and awards are for permanent disability benefits, which are calculated using a permanent disability rating. If the insurance company doesn’t agree with the rating determined by the worker’s physician, they may require the worker to attend an independent medical examination (IME) with a physician of their choosing. This physician will likely provide a lower disability rating and the insurance company will use this rating to lower the amount of benefits being paid.
The worker has a preexisting condition
Injured workers who have a preexisting condition may struggle to prove the injury was work-related. The insurance company will blame the injury on the previous condition to deny benefits.
Difficulty obtaining treatment
If an injured worker needs an expensive surgery, the insurance company may deny or delay the approval of the medical procedure. In these instances, an experienced workers’ comp lawyer will put the necessary pressure on the insurance company to approve the treatment.
The worker’s ability to work is impaired
Some injured workers will not be able to work again, even after completing treatment, meaning they’ll need the maximum amount of workers’ comp benefits.
The worker is receiving other government benefits
Injured workers who are receiving Social Security Disability Insurance (SSDI) benefits may see these benefits reduced if they start receiving workers’ comp benefits.
Upcoming workers’ comp hearing
If the insurance company refuses to give a fair settlement offer, the worker will need to present their case at a hearing. In these situations, it’s critical to have an experienced workers’ compensation lawyer who will fight for the worker’s rights.
California Workers Compensation – TTD
In the California Workers’ Compensation system, TTD is an abbreviation for “Temporary Total Disability”. TTD benefits are available to injured workers who are, according to a qualified physician, are temporarily unable to work as a result of their work-related injury or illness.
TTD benefits provide temporary wage replacement to workers for up to 104 weeks at the rate of 2/3 pay, subject to a certain maximum weekly rate.
To be eligible for TTD benefits, an injured worker must first report their injury or illness to their employer and file a workers’ compensation claim. The employer’s workers’ compensation insurance carrier will then investigate the claim and determine if the worker is eligible for TTD benefits.
It is important to note that the workers’ compensation system in California can be complex, and injured workers may benefit from seeking the assistance of an attorney who specializes in workers’ compensation law to help them navigate the claims process and ensure that they receive the TTD benefits to which they are entitled.
If you believe you may be entitled to TTD benefits due to a work injury or illness, contact us at 714-547-5025.
California Workers’ Compensation – Death Benefits
The California Workers’ Compensation system provides death benefits to the dependents of workers who die as a result of a work-related injury or illness. These benefits are intended to provide financial support to the surviving family members and dependents of the deceased worker.
The amount of death benefits that a dependent is entitled to receive depends on various factors, such as the worker’s earnings at the time of the injury and the number of dependents.
Generally, the death benefits include:
Burial expenses: Up to $10,000 for reasonable burial expenses.
In California, death benefits are usually paid as a flat sum to the beneficiaries, which could include:
$250,000 for one dependent or claimant.
$290,000 to be evenly split between two dependents or claimants.
$320,000 to be evenly split between three or more dependents or claimants.
Many deaths on the job may also involve misconduct of the employer, and if proven, the dependents may be entitled to a 50% increase in all benefits awarded.
If you’re a dependent of a worker who died as a result of a work-related injury or illness, consider consulting with an experienced workers’ compensation attorney to help you understand your rights and options. We can be reached at 714-547-5025.
California Workers’ Compensation – Serious and Willful Misconduct of the Employer
Serious and Willful misconduct in the context of California workers’ compensation law refers to a reckless act or omission by an employer with a disregard for the safety of an employee.
Under California law, if an employee is injured as a result of Serious and Willful Misconduct (S&W) on the part of the employer, the employee may be entitled to 50% additional compensation beyond what they would receive through traditional workers’ compensation benefits. This additional compensation is known as a serious and willful misconduct penalty.
In order to be entitled to potential S & W benefits, the worker ( or dependent(s) ) MUST a special applicant with the Workers Compensation court BEFORE the 1-year anniversary of the date of injury, or the S & W claim will be barred by the Statute of Limitations.
To establish a claim for serious and willful misconduct, the employee must show that the employer had a reckless disregard for the employee’s safety and that the act or omission was a substantial factor in causing the employee’s injury. Often, an expert witness is necessary to prove the S & W case.
Examples of serious and willful misconduct may include an employer’s intentional failure to provide safety equipment or training, intentional disregard of safety rules, or intentional removal of a safety guard from machinery.
If you believe that you have been injured as a result of serious and willful misconduct on the part of your employer, you should consider consulting with an experienced California workers’ compensation attorney to discuss your legal options. We can be reached at 714-547-5025.
Offsite Injuries: Are They Covered by Workers’ Compensation?
Workers’ compensation covers a variety of injuries sustained by workers on the job, from slips and falls to forklift accidents. But what if the worker is injured off-site?
Workers’ Compensation Coverage For Off-Site Injuries
Typically, workers’ compensation covers off-site injuries that are work-related. However it can be difficult to determine if the injury is work-related. Workers’ comp judges will need to decide if the employment caused the injury. Off-site injuries that may be covered by workers’ compensation include:
- Injuries sustained while traveling if:
- The employee is a traveling sales professional with no fixed job site.
- The employer provides a company car for transportation or reimburses the employee for travel expenses
- Injuries sustained during an off-site company-sponsored event, such as a Christmas party
- Injuries sustained during a company-sponsored recreational activity, such as a company fitness program or team-building games
- Injuries sustained during a recreational activity to entertain potential clients
Injuries Not Covered By Workers’ Compensation
If an employee sustained an injury during a lunch break, the employee typically isn’t eligible for workers’ compensation benefits. The employee may only qualify for benefits if the employer benefited from the employee’s actions. For example, purchasing lunch for a boss so that the boss can continue working may be considered a work errand and covered by workers’ comp. However, if the employee runs personal errands during the lunch break and picks up food for coworkers, injuries won’t be covered by workers’ comp.
Injuries sustained during a work commute typically aren’t covered by workers’ comp because their work hours don’t begin until they’ve arrived at the workplace. However, commuting may be covered if the employee is performing work duties while driving. For example, transporting a client or boss may be considered work-related activity.
If you’ve sustained an injury while performing work activities off-site, you may be eligible for workers’ compensation. Insurance companies may look for reasons to deny your claim, and without an experienced lawyer you may not receive the compensation you deserve. Contact Thomas F. Martin, PLC for a consultation. His expertise in workers’ compensation is unmatched in Orange County and he will fight for your rights. Give his office a call today to build your case.
California Workers’ Compensation – Brain Injury
Workers’ compensation in California provides benefits to employees who suffer work-related injuries or illnesses. Brain injuries can be the most complex injuries a worker can suffer because it affects nearly all aspects of life. Loved ones can be affected by the injury as well, often providing care that the insurance company resists providing.
In California, can be any disruption in normal brain function caused by an external force, such as a blow to the head. Brain injuries can range from mild concussions to severe traumatic brain injuries (TBIs). Brain function can also be affected by pain, as well as medications are taken for a work injury. Chemical exposure can also cause brain dysfunction.
If you have suffered a brain injury while on the job in California, you should immediately report the injury to your employer and seek medical attention. Your employer is required to provide you with a claim form for workers’ compensation benefits within one working day of being notified of your injury and immediately provide the proper medical treatment.
Once you have filed a workers’ compensation claim, your employer’s insurance company will investigate the claim and determine whether or not to accept liability. If your claim is accepted, you are entitled to quality medical care for your brain injury, including specialist if necessary.
If your claim is denied, you have the right to appeal the decision. It is important to consider advice from an experienced workers’ compensation attorney who can help you navigate the appeals process.
If you have suffered a brain injury and need help navigating the complex workers’ compensation system, call us at 714-547-5025.
Top Safety Risks In The Warehouse Workplace
The warehouse is a busy workplace with many moving parts — forklifts, workers, truckers, ladders, heavy boxes, and other machinery. The risk of injury at a warehouse is higher than an office, making it especially important to follow safety protocol. Here are the top safety risks in the warehouse and how employees can protect themselves from injury.
- Electrical hazards
Operating machinery exposes workers to electrical hazards, such as electric shock and even electric fire. When electrical problems arise, some warehouse managers ask workers to fix the problem. But unless they’ve received training in electrical work, employees aren’t qualified to address electrical issues. In these cases, it’s best to hire an electrician to avoid electricity-related injuries.
- Not wearing personal protective equipment (PPE)
Some workers must wear protective eyewear, hard hats, goggles, gloves, and dust masks in the warehouse. Failure to wear personal protective equipment could lead to hearing loss, eye injuries, crushing and impacts, respiratory issues, and severe illness caused by exposure to toxic chemicals. Workers should be trained to safely wear, clean, and maintain PPE to reduce the risk of injury.
- Falling objects
Warehouses are designed to maximize storage space, which means workers often stack objects to utilize vertical space. This creates the risk of injury caused by falling objects. Workers should be trained to properly stack items using safe techniques and movements.
- Slips and falls
Holes or cracks in the floor, loose cords, spilled liquids, and unsecured mats increase the risk of slips and falls in the warehouse. Warehouse managers should be on the lookout for any of these hazards and train workers to take the necessary steps to prevent slips and falls.
- Fires
A single spark could ignite stacks of materials and products, spreading like wildfire in a warehouse. Every warehouse should have automatic sprinklers and numerous emergency exits to reduce the risk of injury or death caused by fire.
- Harmful substances
To prevent injury or illness caused by harmful substances, all chemicals must be properly stored and labeled. Workers should be trained to safely clean up spills and dispose of dangerous chemicals.
- Heavy equipment
Operating heavy equipment, such as a forklift, for an extended period of time could cause workers to become lazy or develop shortcuts that could increase the risk of injury. All workers should be taught safety procedures for working near forklifts.
If you’ve been injured while working at a warehouse, contact the best Orange County workers’ compensation attorney for the legal representation you deserve. Thomas F. Martin is just a phone call away!
Common Reasons Workers’ Compensation Claims Are Denied
Workers who file a workers’ compensation claim expect their injury or illness to be fully covered by their employer’s insurer. Unfortunately, there are legitimate instances when an insurance company can deny a claim. Here’s how to reduce the risk of your claim being denied.
- Missed deadline
Taking too long to file the necessary paperwork with your employer can mean missing the reporting deadline, which is used by insurers to weed out fraudulent claims. For this reason, workers need to inform their employer as soon as possible after sustaining a work-related injury or illness. In some cases, it may be necessary to hire a workers’ compensation attorney in Orange County to help file your claim and obtain the benefits you deserve.
- The illness or injury wasn’t work-related
A workers’ compensation insurance company can claim the injury wasn’t work related if:
- There weren’t any witnesses when the injury occurred
- The injury was caused by a hobby or recreational activity, even if it occurred in the workplace
- The illness or injury was caused by a pre-existing condition
- The injury occurred while the employee was on their way to work or going home, or during a break
- The worker didn’t notify the employer when the injury occurred
- The illness or injury was due to horseplay
If the employee was engaging in horseplay, roughhousing, or joking when the injury occurred, the claim may be denied. The injury may be classified intentional if the employee broke safety protocols by engaging in reckless behavior.
- The employee was intoxicated or under the influence of illegal drugs
Workers who are injured while drunk or high on drugs do not qualify for workers’ compensation benefits. In these cases, workers may be terminated if a drug test shows they consumed alcohol or illegal substances while on the clock.
- The employee skipped medical appointments
It’s important to seek medical attention for an injury or illness as soon as possible. If the worker delays treatment in the hopes that the injury or illness will heal on its own, but their condition worsens or doesn’t improve, filing a workers’ compensation claim will likely lead to a denial of benefits.
- The employee accessed out-of-network medical care
When seeking medical care, employees need to check policy requirements and ensure they only see an in-network doctor. The employer should provide the worker with information about which doctors and facilities they can receive treatment from.
What To Do After You’ve Been Injured At Work
Though safety laws have helped reduce the rate of injury at work, accidents still happen. When they do, workers need to know what steps they should take to ensure their injury is properly documented and treated.
- Seek emergency medical treatment
If the injury is life-threatening, workers should seek emergency medical care. Let hospital staff know the injury or illness is job-related and when you’re in a stable condition, contact your employer for further instructions.
- Report the injury or illness to the employer by filing a claim form
It’s important to file a claim with your employer’s workers’ compensation company as soon as possible to ensure your injury or illness is covered. Request a claim form from your supervisor and fill out the “employee” section of the form. Sign and date the form, submit it to your employer, and keep a copy for your records.
The employer will then complete the “employer” section and forward the completed form to their workers’ compensation insurance company. They should also give you a copy of the completed form for your records. The insurance company then has 14 days to mail a letter providing the status of the claim.
- Check the status of your claim
If the claim was denied, workers have the right to challenge the decision. But it’s important to file a dispute as soon as possible. Hiring a workers’ compensation attorney could help increase the odds of a successful claim. In California, workers must file an Application for Adjudication of Claim at the DWC office in the county where they live or the county in which they were injured.
Once the form has been filed, the DWC will send a notice confirming the form has been filed and provide a case number.
- Attend all medical appointments
While the claim is being processed, workers need to attend all medical appointments. Missing an appointment could give the insurance company a reason to deny the claim and withhold benefits.
- Hire a workers’ compensation attorney if your claim was denied
Certain factors make it difficult for injured workers to secure benefits. In these cases, they may need the expertise of a workers’ compensation attorney.
If you’ve been injured on the job, contact Thoms F. Martin, PLC, the best workers’ compensation attorney in Orange County, for legal representation.
7 Tips For Staying Safe In The Workplace
Regardless of whether you work at a desk or operate heavy machinery, the workplace poses safety hazards that could lead to injuries. To stay safe and avoid injuries, here are a few tips every employee should keep in mind.
- Use equipment, machinery, and tools properly
Don’t think that you can figure out how to use equipment properly on the fly. No matter your experience level in the industry, it’s important to approach every new piece of machinery with caution. Take the time to learn how the equipment works and take the necessary steps to protect yourself and others.
- Report unsafe conditions immediately
If you see unattended machinery, loose cords, cluttered spaces, broken glass, spilled liquids, broken lights, or uneven surfaces, report these safety hazards to your manager or supervisor.
- Stay hydrated
Staying hydrated helps you stay alert and focused. Keep a bottle of water nearby to remind yourself to drink water regularly.
- Practice good posture
Whether you’re sitting for long periods of time or lifting heavy objects, it’s important to use the right posture. Use an ergonomic desk and keyboard to minimize strain on the wrists and arms. Remind yourself to sit up straight and keep the shoulders in line with the hips when moving objects. A habit of poor posture will strain the back, neck, and shoulders, leading to serious injury.
- Take regular breaks
Working nonstop may seem noble, but in fact it’s counterproductive. Without regular breaks, employees tend to get distracted, careless, and fatigued, which increases the risk of injury. Take short walks and avoid using your phone during your breaks.
- Be aware of surroundings
If you’re working in a busy environment with many moving objects and people, it’s important to look out for the following:
- Signage indicating hazardous areas and materials
- Emergency exits and procedures in case of a fire, flood, or earthquake
- Unsecure railings
- Items blocking hallways and passageways
- Avoid shortcuts
If you’re running behind schedule, you may be tempted to skip a few steps to catch up. But those steps could be the difference between safety and an injury. Don’t take shortcuts and always follow instructions for using tools and machinery.
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