The length of time it takes to investigate a workers’ compensation claim varies depending on the type of injury reported, the circumstances surrounding the accident, witness availability, the extent of the medical conditions, the availability of documentation, and the cooperation and availability of all parties involved.
California bill SB 1127 would reduce the investigation period for claims in which workers have a presumption of compensability to 75 days from the employer notification of the injury. In other claims, the investigation period would remain at 90 days.
Challenges With Workers’ Comp Investigations
The California Workers’ Compensation Institute (CWCI) conducted a study that found potential problems associated with reducing claim investigation time frames; these include:
- Litigated and denied claims require significantly more time to gather reports and documentation from outside sources. Only 49.2% of litigated claims that are eventually denied have a compensability decision at 75 days.
- Employers are currently liable for up to $10,000 of medical treatment for a claimed injury during the investigation period, regardless of the insurance company’s final decision. Reducing the time frame would reduce the amount of time workers whose claims are eventually denied have to receive $10,000 worth of medical care.
How Workers’ Comp Investigations Proceed
A workers’ comp investigation looks at video surveillance, online social media channels, interviews, and medical reports to determine whether the claim should be approved or denied. The insurance company’s claims team is checking to see if the injury is fake or exaggerated if the injury is job-related, and if the employee is still working.
Investigators will watch employees coming and going from home and doctor’s offices. In addition, they will review the injured employee’s online posts, tagged photos, status updates, and other online activities. Investigators will also interview employees over the phone or in person to see if the injury is valid and work-related. Workers’ comp claims teams may also interview the injured employee’s relatives, close friends, coworkers, and neighbors to learn more about the employee and identify potential fraud.
Legitimately injured workers don’t need to worry about the claims investigations process. Hiring an experienced work injury lawyer in Orange County, CA will help ensure they have a solid case and receive the compensation they deserve. Call Thomas F. Martin, PLC today to schedule a consultation.
Competition for customers in the hotel and restaurant industries, particularly as we emerge from the COVID-19 pandemic, is intense, and the pressure on workers to get work done puts workers at great risk for injury and repetitive motion conditions.
Working in a restaurant and/or hotel is incredibly physical. Prolonged weight bearing, pushing and pulling carts, making beds, cleaning rooms and bathrooms, lifting and carrying heavy items, high risk of slip and falls, vacuuming, and burns are unfortunately common activities that can cause injuries. Repetitive motion injuries – also known as cumulative trauma injuries – are also common. Injurious conditions can include:
– Back and neck damage
– Wrist and hand conditions ( such as carpal tunnel syndrome)
– Chemical exposure/lung injury
– Knee injuries
– Shoulder and elbow injuries
Thomas F. Martin, PLC has helped many hospitality workers obtain workers’ compensation benefits for their injuries.
Your free and confidential consultation is available by calling 714-547-5025.
The simple truth is that in California, undocumented workers qualify for workers’ compensation benefits because all workers are considered employees under California law regardless of immigration status or whether or not the employer is uninsured. However, certain job retraining benefits may be unavailable.
If an employer is unable to offer modified or permanent work based on an injured worker’s medical status, the worker may receive benefits. But if the employer is unable to offer work due to the employee’s immigration status, then the benefits may be unavailable.
This typically occurs after an injured worker is found to be undocumented. Under federal law, businesses are prohibited from hiring individuals who don’t have a legal right to work in the United States.
Once a business owner finds out that a worker is undocumented, they will no doubt take the position that they are required to terminate the employee. Under federal law, violation of laws governing work eligibility can be punishable by fines and criminal prosecution. The use of false employment documents by workers may also lead to fines and criminal prosecution for the worker.
However, California workers’ compensation laws are not in conflict with federal immigration laws because these laws don’t address workers’ comp benefits. Thus, an undocumented worker may be eligible for:
– Temporary disability
– Medical treatment
– Permanent disability
– Future medical treatment
– Other workers’ compensation benefits
California is a “no-fault” state. This means that as long as the injury or condition happened while working, that injured worker is entitled to workers’ compensation benefits. Immigration status is irrelevant.
In some cases, an employer or insurer may (falsely) claim that immigration status is an “excuse” not to provide workers’ compensation benefits. An experienced work injury lawyer in Orange County can help undocumented workers injured on the job navigate the complex workers’ comp system and obtain the benefits they deserve. Don’t let them get away it.
Call Thomas F. Martin, PLC at 714-547-5025 to schedule a free consultation and learn more about your rights.
Losing a loved one is difficult for everyone. Especially when it happens suddenly on account of an unforeseen accident, it is more painful to know that the person could have had a great life ahead. Such accidents are avoided by many but sometimes the worst happens. Workers in construction, factories and shop floors are the most vulnerable to such accidents. Whenever a worker dies, it is the duty and moral obligation of the company to provide his or her dependents with workers’ compensation death benefits. Here is some more information on death benefits included in workers’ compensation.
Why does one receive death benefits?
When a person dies at work, ANYONE who was dependent on them for financial support may be entitled to workers’ compensation death benefits.
Who is eligible for the death benefits?
People who were partially or totally dependent on the deceased may be entitled to death benefits. By law, some relatives are automatically considered to be totally dependents and these are:
· A child under the age of 18
· A child of any age who is physically or mentally challenged to be able to work or earn a living
· A spouse who earned less than $30,000 in the 12 months before the deceased’s death.
· Other individuals qualify for being total dependents or partial dependents but in general, they must be a part of the household, a relative by blood, marriage, or adoption. And if a person relied on the worker in full or partial, they become a dependent entitled to benefits.
What amounts are included in death benefits?
· Burial Expenses: The Workers’ compensation insurance company has to provide expenses incurred by the family for the funeral. Burial expenses up to $10,000 is provided as compensation.
· Death Benefits: Generally (there are exceptions) the benefits are: One total dependent, $250,000; two total dependents, $290,000; for three or more, $320,000 is paid by the insurance company. This amount is released in installments but not less than $224 per week, and under certain circumstances awarded in a lump sum.
· A partial dependent may receive four times the amount they received from the deceased as financial aid.
Thomas F. Martin is an experienced attorney working for workers injured on the job and has worked in the field for over 25 years. If you need any help or information on workers’ compensation, call us for a free case evaluation today.
Anti-employee interests are always thinking about ways to “reform” California’s worker’s compensation laws in their favor.
Take, for example, the last few reforms, which assured increased profits for insurance companies and increased benefits for injured employees. Not surprisingly, the employees ended up on the losing side of the so-called “reforms”.
Recent reforms included changes to “apportionment,” which is a fancy word for discount.
When an employee suffers permanent injuries from work activities, like lifting heavy boxes or inhaling dangerous chemicals, the employee is entitled to money to replace the lost ability to work in the future. “Apportionment” simply means a discount on the money the employer owes for the permanent disability. So let’s call it what it is – a discount.
Now, one of the ways the employer tries to get a discount is to blame the injured employee’s age for the disability. If the employer can convince a doctor in the case that “age” is responsible for part of the permanent disability – even if the employee was able to do the work – then the employer gets a discount of by whatever percentage the doctor blames age.
So, for example, if the doctor says 90% of the reason an employee has back problems was due to “age,” then the permanently disabled employee will only get 10% of what they are owed – even if they were doing the job without any problems before the injury.
Where am I going with this? Simple. Science proves that the aging process can be accelerated by the type of work you do.
For example, a new study found an association between the time spent sitting at work and increased disability. The chance of suffering permanent disability increased by 57% for each sedentary hour at work. And, the increased risk isn’t just to your joints – prolonged sitting also increases your risk across the board – arthritis, cardiovascular disease, diabetes, hypertension, lung disease, and risk of stroke. Think about that when you are spending countless hours working from home.
So next time a doctor blames “age” for some (or most) of your permanent disability, force the doctor and employer to justify the “junk apportionment.” Science-based medical studies have plenty to say about work-forced activities accelerating the aging process. Don’t let them get away with an unjustified discount on what you are owed in lost wages.
With more workers’ compensation “reforms” on the horizon, be on the lookout for even more efforts to limit or eliminate employees’ right to be awarded disability money for the cumulative effects of work activities such as sitting for hundreds of hours for work each month.
Regardless of where you stand regarding a woman’s constitutionally protected reproductive rights, no one will seriously doubt that the opponents of Roe vs. Wade have made countless efforts to limit and overturn the 1973 decision of the United States Supreme Court.
For 50 years, the opponents of Roe waged war on the decision – in the courts, the press, in Congress, and in State legislatures. The foes were persistent and patient. The fait accompli (at least for now) was Trump’s appointment of activist Justices to the United States Supreme Court.
This past Friday was a stunning example of what can be taken away in the blink of an eye when citizens assume that a right will always exist because it’s “decades-old”.
So what the hell does this have to do with the California workers’ compensation system? Let me tell you.
For over 100 years, a California employee has had the constitutional right to obtain medical treatment and wage replacement benefits whenever – and however – they were injured at work. Injuries that occur because of the nature of the work – commonly known as cumulative trauma injuries – are also constitutionally protected.
Much like the enemies of Roe vs. Wade, employers and insurance companies have waged a quiet war since at least the 1970s to limit and even eliminate their responsibility for cumulative trauma injuries in the workplace.
Just as in Roe, the foes of an employee’s constitutional right to obtain medical treatment and recover lost wages for cumulative trauma have spent decades laying the groundwork – in the press, in the State Legislature, and with the courts – to take away an employee’s right to recover for a work injury that occurs over time.
The drum beat for “reform” is here again – an army of employer lobbyists are again trying to wipe out your constitutional right to workers’ compensation protections when your job injures you over time.
Let’s stop another “Roe vs. Wade” style takeaway. People are more important than profits.
And people vote to correct a wrong when important rights are taken away from them.
An injured worker often needs to take time off work to attend doctor’s appointments, obtain treatment, and fully recover. During this time, they deserve medical benefits and wage replacement. But to obtain the compensation they deserve, they must file a claim with their employer’s insurance company. Unfortunately, many insurance companies deny most initial insurance claims, making it difficult for employees to pay medical bills and daily living expenses.
A work injury lawyer in Orange County is qualified to handle the legal aspect of workers’ compensation, as well as helping the worker access the medical services they need to recover. Here are a few signs an injured worker needs to hire an Orange County workers’ compensation lawyer.
1. The injured worker needs surgery.
Most insurance companies have a cap on how much they’re willing to pay for medical expenses. Most of the time, surgery expenses are not covered and a worker’s claim may be denied. In this case, the injured worker will need the help of an experienced workers’ comp attorney to have their claims paid in full.
2. The worker has sustained a permanent injury.
Employees who sustain a permanent injury, such as paralysis, brain trauma, severe burns, amputation, disfigurement, and neck and spine issues are entitled to greater compensation than temporary injuries.
An experienced work injury lawyer in Orange County will file the necessary paperwork and gather the evidence necessary to ensure the worker receives long-term benefits.
3. The worker has received incorrect benefits.
It’s possible that an insurance company will provide the worker with some benefits, but not the right compensation. In these cases, the injured worker needs the help of a work injury lawyer to determine what kind of compensation they deserve and negotiate with the insurance company.
4. The worker has a pre-existing disability or condition.
Workers with a pre-existing disability or condition will need to prove the accident wasn’t caused by their disability. A work injury lawyer will help the worker build a strong case and gather the evidence necessary to back up their claim and receive the compensation they deserve.
Thomas F. Martin, PLC is an experienced work injury lawyer in Orange County, helping workers obtain the benefits they deserve. Give him a call today to discuss your case!
Your on-the-job training should cover some safety precautions about how to avoid workplace accidents and injuries. But, if your workplace is like many others, it will only brush upon what to do after an on-the-job injury and your rights as an injured employee – if at all. We have compiled a helpful and easy-to-follow list of steps that should be taken after an accident or injury that occurs either in your workplace or while you are performing work-related duties.
Hurt in a workplace accident? Consider these general steps:
- Get help: If your injury is severe enough to require immediate medical attention, get it as soon as possible. Some people hesitate to call 911 or be taken to a doctor because they do not know if the medical treatments needed will be covered under workers’ compensation law or insurance benefits. Please do not jeopardize your own health. Always call for help when you need it, no matter the circumstances.
- Tell your supervisor: Every state has its own guidelines as to how long you can wait before telling your boss, supervisor, manager, or superior about a workplace accident as soon as possible. Generally, the longer you wait to report the injury, the more challenges to the claim can arise. If you do not have a chance to immediately tell your supervisor, then you should tell a trusted person to do it for you, and follow up when you can.
- Double-check with your employer: Even though you are the one who was injured and who filled out an injury report for your company, your employer should report it to its workers’ compensation administrator. You should be given paperwork that confirms that the injury was reported.
- Follow-up appointments: Comply with your doctor’s orders while recovering from your injuries. If you have questions, ask the doctor.
- If you are being ignored, get help.
Thomas F. Martin, PLC – an Orange County workers’ compensation firm – has been fighting for the rights of injured employees for more than 25 years. Call 714.547.5025 to schedule a free consultation today.
At Thomas F. Martin, PLC, Orange County Workers’ Compensation Attorney Thomas Martin has helped many injured workers seek fair workers’ compensation benefits after being in a workplace accident. But no matter how much we enjoy our job and serving injured workers, it would be better if there were no on-the-job accidents in the first place. After all, workplace safety is ultimately the responsibility of employers, supervisors, regulators, and parent companies.
Keep these general tips to avoid common workplace accidents in mind whenever on-the-job:
· Slip and trip accident prevention: From retail stores to office locations, slip hazards are a real problem for employees that can result in serious injuries. All walkways should be well-lit, clear of clutter and cables, and dry. If there is a slip hazard, safety cones should be placed around it to prevent people from walking there until the issue is fixed.
· Ergonomic equipment: Repetitive stress injuries (also known as cumulative trauma) have proven to be a health hazard for office workers, especially carpal tunnel and similar wrist and hand conditions that come after long hours spent at a computer. Ask your supervisor for ergonomic equipment that is designed to prevent repetitive stress injuries in particular.
· Full shutdown: Whenever someone services, empties or cleans a piece of heavy machinery, or any equipment with sharp parts, it should be completely shut off, unplugged, and locked out, when possible. Only the person actually servicing the equipment should carry the key to the lockout system, ensuring no one else could possibly turn the machinery back on.
· Stay together: If your job requires you to scale heights, cross precarious planks, or enter any otherwise dangerous area – all hazards common to construction and industrial jobs – you should stay close to a coworker as much as possible. In case there is an accident, someone will be there to call for help immediately.
· Medical kits: There should be ample medical supplies at every workplace for first-aid care and intervention. The larger the worksite, the more first-aid kits there should be. Ideally, it should not take more than one minute for an able-bodied person to reach medical supplies and bring it back to the accident site.
Even with all the best preventative measures in place, you may still get hurt in a workplace accident. The injury can also arise from someone else’s negligence. If you need professional assistance in a workers’ comp claim, appealing one that was denied, or fighting for compensation in the courtroom, know that Thomas F Martin PLC – Orange County workers’ compensation attorney – can help. Learn more about your rights and options today during a free case evaluation – just call 714.547.5025 to begin.
Repetitive stress (or strain) injuries, or RSIs, are the most common occupational health problem in the United States; they cost more than $20 billion a year in workers’ compensation claims. And while outdoor workers typically have a higher risk of accidental injury (logging is one of the most dangerous jobs in the country), many white-collar occupations expose people to traumatic repetitive movements that could lead to nerve or musculoskeletal damage. Here are a few RSIs and the jobs that might increase your risk of experiencing them.
RSI’s are also known as cumulative trauma claims.
CARPAL TUNNEL SYNDROME
There are around 850,000 new cases of carpal tunnel syndrome every year. The carpal tunnel is where nerves and tendons pass from the arm to the hand. One of the nerves, the median nerve, carries “signals” from the brain to the fingers and hand. Carpal tunnel syndrome occurs when the median nerve is pinched by swollen tendons in the wrist and other complications. Repetitive movements that create stress for the tendons can cause this problem. Occupations that experience this type of injury include:
· Factory workers
· Assembly-line workers
· Administrative support workers
· Dental hygienists
· Warehouse workers
· Construction workers
Assembly workers can develop the syndrome since they may use vibrating hand tools, which may increase chances of tendon irritation. Symptoms of carpal tunnel syndrome include tingling, pain, numbness, or weakness in fingers, wrists, or arms. Early treatment can help, but severe cases could require surgery.
Tennis elbow, or epicondylitis, is a condition causing pain on the outside of the arm, where the forearm meets the elbow. Tiny tears in the tendons that connect muscle to bone cause inflammation and can cause pain in your arm. Epicondylitis may make it painful to lift and grip objects and could become chronic and extremely painful. Some employees susceptible to the development of “tennis elbow” are:
· Musicians (such as fiddlers, violinists, and pianists)
· This condition may be treated with exercise, physical therapy, or anti-inflammatory medication, but severe cases might need Botox injections, ultrasonic treatment, or even surgery.
While “tennis elbow” is a type of tendonitis, you can develop this condition in any tendon in your body. Most often, tendonitis can occur in the shoulder, elbow, knee, wrist, and heel, or other parts of the body that are constantly used on a day-to-day basis. Repetitive movements that irritate the tendons can cause tears, and continuous repetition of the same motion can make those tears wider or prevent them from healing at all. Rotator cuff tendonitis is a common condition and will feel like shoulder pain. Jobs that most often lead to rotator cuff tendonitis are:
· Athletes (such as swimmers, tennis players, and baseball players)
Symptoms of tendonitis include pain, weak joints, and swollen, warmth around the area. Tendonitis can heal after a few days of rest, application of ice packs, and anti-inflammatory drugs. More severe cases may need a brace, sling, or splint to keep the affected area from moving. Surgery may be needed in serious cases.
Back pain is a common symptom for many workers. Some workers who might be more prone to developing back injury are:
· Construction workers
· Nursing home caretakers
· Warehouse workers
· Bus drivers
Because the spine is the “column of strength” we depend on for movement and rotating, workers often lift with using leg strength, rather than with the back. Back pain can also be one of the most difficult RSIs to deal with, as we use our spine to stand and sit.
If you’re experiencing pain on the job, don’t wait until your injury becomes debilitating. Consider filing a workers’ compensation claim so you can get the medical attention you deserve.