The workers’ compensation process is designed to protect the injured worker, and to be easy to navigate. If your employer or insurance company does not dispute your claim, you can likely handle it on your own. However, many workers, in order to receive proper compensation, need to hire a California workers’ comp lawyer. If you’re an injured worker in California, the Jones Legal Team is here to help get you everything you’re entitled to.
Below, we list some circumstances under which you should hire a workers’ compensation lawyer.
1. Your employer or insurance company denies your claim.
Your insurance company may try to deny your workers’ compensation claim for several different reasons. They may allege that you filed your claim too late, or that your injury was not work-related. However, you can appeal your denial through the system. This generally requires formal paperwork, gathering evidence, and a hearing of your case. Because of this, a claim denial is a perfect reason to hire an attorney.
2. Your employer refuses to report the injury.
Your company’s workers’ compensation benefits are generally provided by their insurance company. In California, compensation law states that employers and their insurance company must adhere to specific requirements when providing benefits for an injured worker. Your employer is required to:
- Report your injury to the insurance company.
- Give you a Workers’ Compensation Claim Form to fill out.
Refusing to report an injury is a bad sign. They may be aware of potential issues such as safety violations or incorrect insurance. If your employer refuses to report your injury, you need an attorney to intervene.
3. You do not receive your disability benefits or your permanent disability rating is disputed.
Your employer or insurance company may provide medical care as needed, but refuse to pay disability benefits. These benefits are to cover lost wages. If your injury makes you completely unable to work for a period of time, or if you are unable to work as many hours during your recovery, you must receive benefits in both cases.
Employers may also try to dispute your disability rating. Your benefits are calculated based on this rating, and the rating is assigned by your doctor. Insurance companies or employers may try to dispute this rating in order to justify paying less in benefits. A workers’ compensation lawyer is essential to receiving your full disability benefits.
4. Your employer blames your injury on a preexisting condition.
Let’s say you have a preexisting condition, such as a knee injury from a car accident. If you injure your knee at work, your employer may try to blame the work injury on your preexisting condition.
5. Your employer fires you after your injury.
California compensation law prohibits employers from terminating employees for sustaining an injury. If you are fired for filing a claim, you have legal recourse. Your employer may not treat you unfairly or retaliate against you for any of the following:
- Settling your claim with your employer.
- Winning your case.
- Announcing your decision to file a claim.
- Submitting a claim to your employer.
- Getting a disability rating from your doctor.
If your employer treats you unfairly for any of the above, they could incur more penalties. These penalties might include money or fines paid directly to you.
6. You are receiving other government benefits.
If you receive Social Security Disability Benefits, they might be reduced if you receive workers’ compensation benefits. An experienced workers’ comp lawyer with the Jones Legal Team can help minimize this reduction.
7. You are having trouble with the doctor your employer chose.
If your company has a network of medical care providers, you may be limited to choosing a doctor from that list. Physicians from this list might not seem to care as much as your trusted primary care physician. Unfortunately, you are still limited to choosing from that list to find a doctor who is more accommodating to you.
Making changes in your medical care after a work injury can be complicated. A California workers’ comp lawyer is best-equipped to see that you get the help you need.
8. You are unsure if your full benefits have been provided.
While the workers’ comp system is intended to be simple for the average injured worker, it can be very complicated. You might not know how much you should get for your injury, or if you should get benefits at all.
Below are some guidelines on what you’re entitled to:
- Fully paid medical treatments, appointments, surgeries, or other procedures related to your work injury.
- Two-thirds of your average weekly pay for disability benefits.
- Benefits based on the severity of your injury.
Workers should be able to trust their employers to get them the benefits they deserve. Unfortunately, many employers and insurance companies will try to pay you as little as they can, despite your entitlement to more.
If you fear your employer gave you bad advice, incorrect information, or failed to cover some of your medical costs, you need an attorney.
9. Your employer refuses to offer modified work if you cannot perform your previous job.
Your doctor might tell you that you can no longer perform your previous job because of your injury. Even so, you need a job to support yourself financially. If your doctor permits you to return to work, but your employer does not cooperate by offering a modified position, you might receive additional compensation.
These “supplemental job displacement benefits” get you the training you require to enter a different line of work. However, you must prove two things to quality for these benefits.
- Because of your injury, your doctor has given you a permanent work constraint.
- Examples of work constraints include:
- Bending or twisting
- Weight lifting limits
- Unsafe environments
- Pushing or pulling
- Lifting objects overhead
- Standing or walking for long periods
- Examples of work constraints include:
- Your employer does not offer alternative work that accommodates those constraints.
If your employer does not offer accommodations, you might be able to receive a retraining voucher. This allows you to retrain, as the name suggests, at a technical or vocational school. It provides up to $6,000 toward retraining.
If your employer refuses to, or is unable to, accommodate your work restrictions, it is essential that you call a California workers’ compensation attorney.
10. Your employer offers to settle for your claim.
If your work injury-related disability is permanent, your employer might offer to settle your claim. These settlements often do not cover the full value of your disability. Have the settlement reviewed by an experienced attorney. They will have knowledge of average settlements for comparable cases.
Insurance companies often do not have your best interests in mind while attempting to settle. They might attach nefarious terms to your settlement, such as a loss of medical care or additional benefits.
11. Your employer is not making progress on your claim.
If you ask your employer repeatedly about progress on your claim with no results, you should speak with an attorney immediately. They should be able to speed up the process. Getting your benefits might be essential to paying your bills, so you cannot afford to wait.
California’s workers’ compensation law penalizes employers who drag their feet to get benefits to their employees. This penalty could amount to up to 25% of your total compensation that you have not received. An experienced California workers’ comp lawyer will get you the benefits you deserve.
Call California Workers’ Comp Lawyer Jones Legal, Inc.
If you have questions about what to do after filing for workers’ compensation, or if your employer is making the process difficult, Jones Legal, Inc. is here to help. Our experienced California attorneys will get your entitlements to you. Contact our offices in Riverside today to get your case in the right hands. Call 951-742-7213 for a free consultation, or visit our website to fill out our online intake form.