If you have been injured or become ill on the job, you should be entitled to workers’ compensation benefits. To discuss what compensation might be available to you, connect with a San Bernardino personal injury attorney today. Read on to learn more on how the claim process works and how a workers’ compensation attorney can support your successful completion of the process while making the most of your benefits.
Am I Entitled to Workers’ Compensation for My Work-Related Injury or Illness?
If you suffered an injury or illness as a result of your work, you are entitled under California law to compensation for lost wages and medical bills through workers’ compensation insurance. You must prove that your medical condition happened in the course of your employment and that you needed medical treatment and/or time off work due to your injuries.
Some common work-related injuries include:
- Concussion and brain injury
- Back and spinal injuries
- Neck injuries
- Fractures
- Soft tissue injuries
- Repetitive strain injuries
- Toxic exposure
- Amputations
- Mesothelioma
- Burns
- Hearing a vision loss
Workers’ compensation insurance is “no-fault,” which means you can receive benefits no matter why the accident happened or who might be to blame. This makes it simpler to begin receiving benefits than in a fault-based claim.
This also means that you cannot blame your employer for your injuries. Workers’ compensation insurance will be the sole source of compensation for your lost wages and medical bills, with your employer not being liable or subject to a personal injury lawsuit to collect damages. This is one reason why it is often so important to maximize your workers’ compensation claim.
Possible Third-Party Claims
When you are severely injured, your damages may extend beyond medical bills and temporary lost wages while you recover from your injury. However, when your injury happens on the job during most circumstances, your recovery will be limited to workers’ compensation benefits. You cannot seek additional compensation for pain and suffering and other intangible losses.
It is important to have an attorney who can identify when a third party – not affiliated with your employer – was negligent and responsible for causing your accident. In this situation, you may be able to bring a lawsuit for additional compensation, including pain and suffering. A workers’ compensation attorney can help advise you what your best options are given the facts and circumstances of your case.
Getting Proper Treatment
With some workers’ compensation claims, you are able to choose your own initial doctor to treat your injury or illness, but only if you took proper steps prior to your injuries. If you see your own physician and the insurance company did not approve it, you may find it difficult to be compensated for your medical expenses. This is only one way that insurers work to challenge workers’ comp claims and minimize benefit payments.
When claims are improperly denied or delayed, you might have the option of an appeal, attempting an out-of-court negotiation, or filing a lawsuit. An experienced workers’ compensation attorney can help you determine what the best option is to collect on your claim as soon as possible.
Insurance Companies Profit by Minimizing Claims and Payments
When you file a claim for workers’ compensation, it is important to remember that the insurance company does not work for you – they work for profit. Workers’ compensation insurance companies collect premiums from employers as their revenue, and when workers file claims, profit is increased by paying out on as few claims as possible. On approved claims, the insurer can still try to limit the amount of benefits paid.
Insurance companies have adjusters to carefully review claims, looking for ways to challenge different aspects of the claim. Some denials are because the insurer claims:
- That your injury was not work-related
- That your injury was preexisting
- That you did not need all the medical treatment you received
- That you did not need to miss all the work you did
- That you do not have a disability under the law
With an experienced San Bernardino workers’ compensation attorney on your team, your claim will include sufficient evidence of your work injury and have a greater likelihood of success.
An Initial Denial Requires a Complex Appeal Process
The process of applying for your workers’ compensation claim can be complicated, and any errors or omissions can lead to your claim being denied. When your worker’s compensation claim is denied, you will have the option of appealing the decision, and a workers’ compensation attorney can navigate the appeals process for you.
First, your attorney can try to negotiate with the insurance company directly to get them to reconsider. If these negotiations fail and the insurer upholds the denial, your lawyer can file an appeal with the California Workers’ Compensation Appeals Board (WCAB). If the denial involves doubts that a work injury arose from employment or happened in the course of employment, you might be assigned to a priority conference, which can end in a quick decision.
If the WCAB finds in your favor, the judge can award you benefits. However, if the WCAB finds in the employer’s favor, the injured worker can appeal the decision to a Circuit Court or Superior Court. You want the right legal help during this process.
Workers’ Compensation Attorneys Negotiate For You, Minimizing Your Stress
One of the most important values associated with hiring a workers’ compensation attorney is the fact that your attorney steps into your shoes and handles all of the negotiating with the insurance companies and filing of paperwork. This takes the stress off of your day-to-day life so that you can focus on recovering from your illness and injury. Let your attorney negotiate with the insurance company to get the most compensation for your injury or illness as soon as possible.
Connect with a San Bernardino Workers’ Compensation Lawyer Now
Reach out to an experienced San Bernardino workers’ compensation lawyers at The JLF Firm today to schedule a free consultation. Our legal team can advise you on your best chances of a successful claim or appeal and how to make the most of your compensation.
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