Workplace accidents, injuries, and illnesses can disrupt your life in many ways. If you would like to discuss your rights to workers’ compensation benefits, reach out to an El Monte personal injury lawyer directly. We can review your situation and help with filing an initial claim, appealing a claim denial, or other concerns you might have.
What is Workers’ Compensation Insurance?
Workers’ compensation insurance provides both wage replacement and medical benefits to workers when they are injured or fall ill on the job. In California, all employers are required to carry this coverage, even if a company has only one employee, and the penalties for not having proper coverage can be costly.
Workers’ compensation is no-fault, which means that you do not have to demonstrate who or what was to blame in order to qualify for benefits. Workers might even suffer injuries due to their own mistakes and can still have a successful claim. However, this also means that workers cannot file injury lawsuits against employers for negligence, which limits the compensation they might receive. Workers’ compensation insurance will be your primary source of compensation for medical treatment and missed work stemming from your work-related injury or illness.
If you have been injured or become ill as a result of work-related activities, you should be entitled to benefits through a workers’ compensation claim. Some claims can hit roadblocks, but a workers’ compensation attorney can help you get the outcome you deserve.
When Should I Contact a Workers’ Compensation Lawyer?
If you have experienced an illness or injury from your job, the time to contact a workers’ compensation attorney is as soon as possible after the necessary medical treatment. A workers’ compensation attorney can help you with the initial filing process, which requires that the claim be completed accurately and in line with specific procedures and that sufficient evidence is provided for the insurance company to be able to verify that you qualify for benefits.
While a workers’ compensation attorney can be especially helpful with the initial filing of your workers’ compensation claim, they can help later in the process if you have already filed the claim yourself. Many people who file their own claims receive denials, and the right attorney can also navigate the appeal process for you.
Challenges with Workers’ Compensation Insurers
Many people do not recognize the reality that the insurance company responsible for paying workers’ compensation claims does not work for them. Injured workers often expect to file a claim and receive benefits, though it is not always that simple.
Insurance companies are for-profit organizations, and they generate their profits by minimizing the amount they pay to claimants. This means that insurance adjusters will look for any way to challenge and deny claims from injured workers. Some common challenges might include:
- Your injury was not work-related
- Your injury is not as serious as you claim
- Certain medical treatment or time off work was unnecessary
Insurance investigators and adjusters will be watching to see if you engage in activities that imply you should be working or healed from your condition. Having help from the right attorney can ensure you avoid mistakes that can jeopardize your claim, as well as have a legal advocate who will stand up to insurers for you.
Workers’ Compensation Claim Denials
When you file your initial claim, the last thing you likely expect is to receive a denial. However, insurance companies deny claims for many reasons, including:
- Incomplete claim information
- Missing claim filing deadlines
- Insufficient evidence provided with your claim
- Your injury or illness does not qualify for benefits
When your initial claim is rejected, you then must proceed through the appeals process to fight for your workers’ compensation. The appeals process is even more complex than the initial filing process and adds additional time to the processing of your claim before you are able to receive the benefits you need.
Workers’ Compensation Claim Appeals
Moving through the appeals process is difficult and time-consuming. You must follow specific procedures and deadlines, and you might even need to bring your case before the state workers’ compensation appeals board or to civil court. This is not something that you should be trying to decipher while you are already dealing with serious medical conditions.
An experienced El Monte workers’ compensation attorney has been through the process and knows what evidence to include in support of your immediate appeal with the insurance company. This might include occupational or medical expert opinions, additional medical records, or other information that supports your claims.
It is important to remember that if the first stages of appeals are unsuccessful, a lawsuit will be your last option, and you want to present the strongest record in court. An incomplete appeal can make for a difficult case to win, and ultimately, you may be unable to collect your benefits. Always have an attorney handling the entire appeals process.
Seeking the Benefits You Deserve
Workers’ compensation benefits are critical for those facing the aftermath of workplace injuries and illnesses. Benefits can cover:
- The costs of all medical care needed for your condition
- Partial income replacement if your injury caused you to miss work and lose wages
- Disability benefits if you cannot work for some time – or ever at all – following your injuries
- Death benefits for family members following fatal injuries
These benefits are limited due to the no-fault system, but they can provide the financial support you need after an injury. Our attorneys can also examine whether you are eligible to file a third-party claim to obtain additional compensation.
Connect with an El Monte Workers’ Compensation Lawyer Today
Workers’ compensation claims can be complicated and stressful – when you are already dealing with the stress of your injuries. Never hesitate to seek assistance from an experienced El Monte workers’ compensation lawyer. Do not wait to schedule a consultation with our legal team at The JLF Firm to discuss your case and pursue the maximum compensation available to you. We can help you from the moment you suffer injuries through your final appeals, when needed.
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