Getting injured at work is a very real possibility for California employees, especially those in dangerous industries like construction, manufacturing, healthcare, and transportation. When a workplace injury does occur, the workers’ compensation system makes it easy for employees to get the benefits they need.
While the workers’ compensation system is generally very straightforward, disputes may arise. If you’re facing pushback on a workers’ compensation claim or dealing with a fraudulent claim, an attorney can help. Explore our list of verified Orange County workers’ compensation attorneys to find the right one for your claim.
After an employee is injured, they report the injury to their employer. From there, they seek out medical care from an approved care provider while the employer files the claim with their workers’ compensation insurance provider. Once the claim is approved, the employee is entitled to receive medical care paid for by the insurance company, temporary disability payments, and other benefits as needed. Other benefits include retraining coverage for employees who cannot return to their previous line of work, permanent disability for those who will never recover fully from their injury, and death benefits to family members of deceased employees.
The system protects both parties. Employees are guaranteed to receive limited income replacement and covered medical care. Employers are legally protected from personal injury claims.
California, known for its extensive workers’ rights, also grants them substantial protections in the workers’ compensation system. An employer is required to provide a claim form to an employee no later than one day after being informed of their injury. During that time-frame, they must also authorize medical treatment up to a total cost of $10,000 while waiting for the claim to go through the insurance company. The insurance company only has 90 days to deny the claim.
Perhaps the most common legal issue that arises in this field is a denied claim. Workers’ compensation insurance companies have a wide variety of reasons for denying claims, but they often deny valid claims. When this happens, the injured employee can take their case before a judge. This involves filing the Application for Adjudication of Claim, submitting necessary documentation, and notifying the insurance provider of their intent to file.
Another issue that may arise is retaliation. While employees are legally permitted to file workers’ compensation claims, regardless of who is at fault for their injury, some employers do attempt to discourage workers’ compensation claims. They may do this in an effort to make their statistics look better or avoid an increase in premiums. If an employer decreases an employee’s hours, denies them advancement opportunities, or fires them in retaliation for an injury report, the employee may have to take further legal action.
The workers’ compensation system in California is highly regulated. Whether you fall on the employer or employee side of the equation, it’s a good idea to have an attorney advocating for you. Use the resources and attorney listings on this page to reach out to an Orange County workers’ compensation lawyer that can help you with your claim.