The workplace is meant to be a safe place where you can go and contribute your time in exchange for the earnings you rely upon to support yourself and your family. Unfortunately, the workplace is not always the safest place to be, and injuries and illnesses on-the-job will lead to costly medical bills and also related lost earnings.
When this happens, you are entitled to workers’ compensation benefits, although they are not always approved or paid out to fully cover your damages. Fountain Valley workers’ compensation lawyers have the knowledge and experience to help you on your case.
Common Work-Connected Injuries
There are common injuries in the workplace that vary depending upon the industry and requirements of the workers in it. For example, construction workers experience falls at a higher rate than other occupations, while office workers might develop repetitive strain syndrome more often than other industries. In the U.S., work-related injuries are common - in fact, there were 2.8 million nonfatal work-related injuries and illnesses in 2019 alone.
When it comes to falls or motor vehicle collisions, like construction workers or truck drivers might experience, common injuries include soft-tissue damage, neck and back injury, concussions and traumatic brain injury (TBI), and nerve damage. Office workers might develop carpal tunnel syndrome often in the modern workplace, a form of repetitive stress syndrome that can cause nerve damage and ongoing pain that can require surgery or make someone unable to work at all.
CA Workers’ Compensation: In Brief
Experiencing an injury or illness on the job entitles you to benefits through workers’ compensation insurance. In the state of California, employers are required to carry workers’ compensation insurance, which is a no-fault system. This means that as an employee, you are guaranteed certain benefits, and your employer is guaranteed not to be sued for the related accident or condition. This is generally a positive trade-off for both parties.
While you are meant to be covered by workers’ compensation without question if you are injured or become ill on the job, insurance companies do not always pay out on proper claims or pay enough to cover your full damages to which you are entitled. The California Division of Workers’ Compensation provides oversight for the state’s workers’ compensation program and a way that you can appeal denials of your benefits.
What Benefits Can I Seek in Fountain Valley?
Being injured on the job entitles you to workers’ compensation benefits to cover two primary areas of costs - medical bills and lost earnings. The medical bills that are covered through your workers’ compensation insurance include both short and long-term medical care, such as emergency room bills, surgery and hospitalization, medication and medical devices, as well as ongoing treatment and rehabilitation that might be necessary from the injury. The severity of your medical condition will determine the benefits available to you and how long they are received, which is measured by the impact of the injury or illness upon your occupational health and ability.
How to File Your Workers’ Compensation Claim
Your workers’ compensation benefits do not automatically kick in after you have been injured or become ill on the job. The process begins with you filling out your portion of the application and including any evidence in support of your position, then submitting that to your employer. To ensure things are timely processed, keeping track of the date you submit the application is important, something a certified letter or a workers’ compensation attorney can provide.
Once your employer has your portion of the application, they have to fill out their own side, then submit it to the insurance company. Workers’ compensation insurance companies profit by generating as much revenue as possible from premiums while paying out on as few claims as possible. This makes having a comprehensive and persuasive claim particularly important.
Whether or not you have sufficient evidence in support of your claim is something that the insurance companies determine, and you might not know what they are looking for. An experienced workers’ compensation attorney knows what the insurance companies are looking for, and how to file a successful initial claim or effectively have a decision overturned through appeal.
Most Common Issues Your Claim Might Encounter
The insurance companies, as noted above, do not make profits by approving everyone’s claim and paying out the full amount. It is, in fact, just the opposite, and workers’ compensation insurance companies might deny or reduce claims for a variety of reasons. Some reasons for rejection are based upon a lack of evidence that justifies their decisions, and others are meant to delay or reduce the amount paid out. Common reasons your claim might be denied are:
- An incomplete or inaccurate application
- Challenging the severity of your injury or illness
- Requiring you to visit their doctor for re-assessment
- Claiming that your condition was pre-existing
- Claiming that you can return to work without any issue
Knowing what motivated the insurance company is difficult for you to know unless you have processed a number of such claims, and ideally, this is your first and only work injury. An experienced workers’ compensation attorney in your area will have worked on a number of such cases and knows what evidence to include in your initial claim to support success or how to file an appeal that leads to an overturning of a denial so you can collect your benefits as soon as possible.
Connect with a Fountain Valley Workers’ Compensation Lawyer Today
A workers’ compensation attorney on your side as soon as possible after you have received treatment and been assessed for your injury will support the fastest and fullest payment on your workers’ compensation claim. Recovering from your injury, getting on with your life, and, as necessary, into recovery and rehabilitation is your number one priority, and handling the claim process is the priority of your workers’ compensation lawyer. To consider how to best resolve your claim and receive the best possible benefits, schedule a consultation now.