12 Reasons Why You Need a Workers’ Comp Attorney

If you suffered injuries in an accident that occurred while you were on the job, you might be eligible to pursue a claim for workers’ compensation benefits through your employer’s insurance company. However, if you file a claim, you should have experienced legal representation on board in your case. You cannot count on your employer’s insurer to fight for your legal interests or offer you fair compensation for your injuries. In fact, that insurance company is your direct adversary in any workers’ compensation claim that you file. 

If the insurance company is refusing to compensate you appropriately for your injuries, a California workers’ comp attorney can take your case to a hearing and pursue the best possible result on your behalf. Your lawyer can introduce evidence and will work hard to maximize the monetary benefits you deserve for your work-related injuries.

What follows are 12 reasons why you should retain a workers’ comp attorney in California to represent you throughout your entire case. 

Your Employer Is Refusing to Pay Anything

If you suffer an injury or illness while you are working at your job and while performing a job duty as an employee, you are entitled by law to receive California workers’ compensation benefits. As part of those benefits, you may be eligible to receive compensation for your:

  • related medical expenses from your injuries
  • a portion of your lost income
  • mileage reimbursement
  • various permanency benefits 
  • job restraining benefits, if you cannot work at your prior job

Entitlement to these various workers’ compensation benefits is extremely straightforward. However, there are many reasons why an insurance company may deny you payment. For example, the insurance company or their representatives might allege that you did not actually suffer your injury while you were working at your job.

You Have Not Received Disability Benefits

While some employers and their insurance companies will pay you medical benefits, they may refuse to pay you disability benefits for your lost earnings. Pursuant to workers’ compensation law in California, you are entitled to receive a portion of your lost income if your injuries prevent you from working. If your employer refuses to compensate you for these benefits, a workers’ compensation attorney can help you take the necessary legal action.

Your Employer Is Dragging Its Feet on Paying Benefits

Some employers continually tell their injured employees that benefits are coming. However, for whatever reason, these benefits never show up. If that has happened in your case, you should speak with a knowledgeable California workers’ compensation lawyer as soon as possible. Under California law, a mechanism exists that may penalize employers who fail to pay out the necessary benefits to injured employees in a timely manner. In some instances, that benefit amount can be as much as 25 percent of the total benefits award you are eligible to recover through the system – and that you have not yet received.

Your Employer Will Not Report the Injury

Although employers have a legal duty to compensate workers for injuries they suffer on the job, it is really the employer’s insurance company that actually makes the payout. Pursuant to California law, an employer must notify their insurance company about your injury within a reasonable amount of time via email or phone. If you learn that your employer has not reported your injury or injuries to their insurance company, you should take legal action right away and retain a skilled workers’ compensation attorney to represent you.

You Are Having Trouble Communicating with the Employer’s Doctor

If you suffer an injury while working at your job, you will typically have limited choices regarding the medical providers with whom you can treat. Some employers and workers’ compensation insurers utilize a medical provider network (MPN). Your employer will provide a list of treating medical providers from which you must select a doctor. In some instances, a designated medical provider on the list may not provide you with adequate care or express sufficient interest in your medical situation. In that instance, you can switch to a different doctor.

If your employer or their insurance company does not have an MPN, you can switch to a doctor of your own choosing for ongoing medical treatment. However, in some circumstances, it can be difficult to find a treating doctor outside of a workers’ comp MPN. If you do feel that you need to switch providers because you’re not receiving quality care, an experienced California workers’ comp attorney can assist you with that process.

The Employer’s Doctor Says You Are Ready to Go Back to Work When You Are Not Comfortable Doing That

Many times, MPN doctors have an incentive to release individuals back to work before they are ready. In fact, many MPN doctors who want to continue accepting patients through the MPN network will essentially do what insurance companies and their adjusters say. In addition to creating potential ethical problems, such action on the doctor’s part may result in an injured worker returning to the workplace before they are truly ready.

In most situations, if a doctor says you are ready to go back to work, you must do so – or you may risk losing significant benefits. However, in some instances, you may be eligible to obtain a second opinion from a different medical provider. Doing so can be a complicated process, but a skilled workers’ comp attorney can help you take the necessary steps to obtain this second opinion.

Your Employer Will Not Offer You Alternative Work After Being Released Back to Work

In some instances, workers who suffer serious injuries at their jobs (such as spinal cord injuries) are unable to return to the same occupation. If that happens in your case, you need to have some way to earn money.

If a medical doctor releases you back to work but gives you light duty or modified work duties, your employer needs to supply you with a job that follows those restrictions. If your employer is unable to do so, you may be entitled to receive various additional benefits called Supplemental Job Displacement Benefits.

To qualify for these benefits, you must demonstrate that:

  • Your medical doctor informed you that your workplace illness or injury caused a permanent work restriction.
  • Your employer cannot or has not offered you alternative work (or a modified job) that follows these medical restrictions.

Your Employer Blames Your Condition on a Preexisting Condition

Employers and their insurance companies have a strong disincentive to pay you money. After all, they may lose a significant amount of money if they have to pay out a large workers’ compensation benefits award. Consequently, insurance companies will look for any excuse to avoid paying out significant monetary benefits to injured workers. 

They may also review your medical records and attempt to blame your current injuries and symptoms on a prior injury, medical condition, or comorbidity. A knowledgeable workers’ compensation attorney can help you refute those claims by pointing to the appropriate medical treatment evidence in your case. 

You Are Unsure If You Are Getting All of the Benefits You Are Entitled to Receive

Many injured workers blindly trust their employers and their insurance companies to award them the total amount of benefits they deserve. However, many injured workers are not aware of all of the benefits they may be entitled to receive in their case. A skilled workers’ compensation attorney will be on your side and can determine the benefits you are eligible to recover through your claim.

You Have Been Offered a Lump Sum Settlement for Your Workers’ Comp Claim

Many employers and their insurance companies will offer injured workers a lump sum settlement to resolve their claims. However, these offers are oftentimes far less than the claim’s actual value. Moreover, if you accept a lump sum offer, you are likely prohibited from re-opening your claim or obtaining additional medical treatment if your condition worsens in the future. A skilled workers’ comp lawyer in your area can determine if a particular settlement offer is reasonable – and worth accepting – in your case.

You Were Fired After Your Workplace Injury

California law prohibits employers from firing individuals who suffer injuries while they are on the job. In fact, this practice amounts to wrongful termination. If an employer wrongfully terminates you after suffering a workplace injury, an experienced attorney can help you take the necessary legal steps to win your case.

You Are Receiving Other Government Benefits

Workers who are unable to work at any job or in any capacity may be eligible to receive Social Security Disability Insurance (SSDI) Benefits. However, if you receive these benefits, your workers’ compensation benefits may be subject to reduction. A skilled workers’ compensation attorney can help you lessen or eliminate the reduction on your workers’ comp benefits in this situation.

Schedule Your Appointment Today!

After suffering an injury on the job, many workers are unsure of what to do or where they should turn. A knowledgeable California workers’ compensation attorney can answer these questions and others as they move your case forward. Your lawyer can then help you maximize the total benefits you recover compensation for your workplace injury or illness.