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Workers' Compensation Benefits: Frequently Asked Questions

Posted by Emily Ruby | Aug 24, 2021 | 0 Comments

Workers compensation frequently asked questions

If you have been injured in a workplace accident, you may have a number of questions about how you can seek compensation to cover medical expenses, lost earnings and other losses.

Our work injury lawyers represent injured workers in third-party lawsuits, which are typically worth much more than workers' compensation benefits.

However, many workers who have been injured on the job should know their rights with regard to workers' compensation benefits. This page aims to answer some of the most common questions we are asked with regard to workers' compensation.

What is workers' compensation?

Workers' compensation is a state-mandated insurance program that provides benefits to employees who are injured on the job. Under California law, workers' compensation is mandatory for all employers even if the company has only one employee.

California law requires business owners to carry workers' comp insurance for employees who regularly work in California, even if their business is headquartered in another state. Generally speaking, an employee with a work-related injury or illness can get benefits regardless of who was at fault.

What are my rights if I'm injured on the job?

You have the right under California law to file a workers' comp claim without being retaliated against. Acts of retaliation may include being fired, demoted or laid off because you filed a claim. Any such retaliation is illegal. You also have the right to file an appeal if your workers' compensation claim is denied. You have the right to receive medical treatment and all the other workers' compensation benefits for which you qualify.

If your injury was caused by a third party, you may also be able to file a third-party lawsuit against that individual or entity in addition to filing a workers' comp claim.

Will workers' compensation cover me if I'm injured at a location other than my workplace?

Yes, as long as your injury occurred when you were working, you will be covered by workers' compensation. For example, if you injured yourself while on a business trip or if you were injured in a car accident while on the job, you will be covered by workers' compensation.

Does workers' compensation cover long-term injuries and illnesses?

Workers' compensation doesn't just cover injuries caused by an accident such as a fall. You can also receive compensation for injuries resulting from long-term injuries such as those caused by repetitive stress. Depending on the circumstances, you may also receive benefits for illnesses that you developed because of chemical or other types of exposure at work.

Can I get workers' compensation if I get COVID-19 on the job?

This depends on the nature of your work. It can be challenging for employees to prove that they contracted the virus because of workplace exposure. Generally speaking, for infectious diseases such as COVID-19, you must be able to show that the particular nature of your job exposed you to a higher risk compared to the general public or other workers.

For example, if you are a healthcare worker or work in a grocery store or are a "frontline worker," it may be easier for you to qualify for workers' comp benefits.

Will workers' compensation cover my medical bills?

Workers' comp will pay for medical expenses that are necessary to diagnose and treat your work-related injuries. It also provides for temporary and permanent disability payments. However, workers' comp benefits may not necessarily pay for other expenses such as cost of rehabilitative treatments or future surgeries and ongoing treatment and care.

This is why it may be important for workers to look into whether they may be able to file a third-party lawsuit, which will cover these types of expenses.

How much money will I receive?

The actual amount of money you receive as part of workers' comp benefits depends on a number of factors including the nature and extent of your injuries and how much you worked prior to your injury. The amount of temporary total disability injured workers receive in California is two-thirds of their average weekly wage, which is calculated depending on the number of hours worked weekly.

Permanent disability benefits are calculated based on your ability to work currently and in the future. However, even these types of disability benefits may not fully cover the pay you lost as a result of your injury.

Are all employees covered under workers' compensation insurance?

No, not all employees are covered. It depends on the type of work you do and the terms of your contract. For example, temporary workers including farm workers, domestic employees or seasonal workers may not be covered.

Can I be treated by my own doctor if I'm injured on the job?

In California, you may be able to go to your primary care physician after a work-related injury, but only if you have healthcare coverage for medical treatment unrelated to work injuries, if you've given your employer written notice before your workplace injury and if your doctor has agreed in advance to treat you for your work-related injuries or illnesses.

If you have not pre-designated your personal doctor, you probably will not be able to choose the initial physician you see for your treatment. When the employer or its insurance company has established a medical provider network or MPN, you will typically choose a doctor from that network.

The exceptions to this rule are when you require emergency medical care and when your employer has not provided you with some legally-required notices and information.

Can I appeal if my workers' comp claim is denied?

If your work injury claim is denied, you will get a letter explaining the reasons for the denial and information about the appeal process. You can also get more information about the appeal process on the state's website. It is important to follow the instructions properly and file within the required deadline.

Will I get a settlement in a workers' compensation case?

A majority of workers' comp cases are resolved through a settlement with the insurance company. However, that might not be the case with every claim. For example, if you have suffered relatively minor injuries, you may decide to accept the benefits paid by the insurance company.

However, if your injuries are serious, you can negotiate a work injury settlement with the insurance company. In some cases, you may be able to claim additional compensation by filing a third-party claim. An experienced Los Angeles work injury lawyer can help guide you in this regard.

How can I file a third-party claim?

In cases where a third party such as a contractor, property owner or defective product manufacturer causes your injury, you may be able to file a personal injury lawsuit against that entity or individual in addition to seeking workers' comp benefits.

A third-party lawsuit will offer compensation for expenses that won't typically be covered under workers' compensation insurance including rehabilitation costs, loss of earning capacity, lost future income and pain and suffering. Your Los Angeles work injury lawyer can help determine whether you have a viable third-party lawsuit.

If you have been injured on the job, the experienced Los Angeles work accident lawyers at Greenberg and Ruby Injury Attorneys can help you better understand your rights and options. We will also help evaluate your case to determine whether or not you have a third-party claim. Call us at (323) 782-0535 for a free consultation and comprehensive case evaluation.

About the Author

Emily Ruby

Attorney Emily Ruby specializes in complex cases, many of which involve catastrophic injuries and deaths. Mrs. Ruby has personally obtained more than $30 million in compensation, including numerous mid-seven figure settlements.

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