If you’ve suffered a workplace injury in Fremont and need assistance with your workers’ compensation claim, contact the Fremont personal injury attorneys at OnderLaw today. We have extensive experience with workers’ compensation claims of all types, and we know how to deal with insurance companies that seek to deny your claim. Call today for a free consultation, and let us help you get back on your feet after a workplace injury. Call OnderLaw now.

What Is Workers’ Compensation?

Workers’ Compensation (WC) is a state-mandated insurance program required for all employers in California. It provides benefits to workers who suffer injury or illness while on the job and to families and loved ones of workers killed on the job. It is a no-fault system, meaning that an injured worker doesn’t need to prove that their employer was negligent to receive benefits, only that the injury or illness is work-related. To receive benefits, most WC policies require that employees agree not to sue their employer in court. The system minimizes the impact of work-related injuries and illnesses on employees and employers alike.

Although state law requires that employers carry workers’ compensation insurance, private insurance companies still administer the policies, which can make navigating the WC policies and procedures problematic for an injured worker.

Who Qualifies for WC Benefits?

Your employer’s WC insurance policy covers almost any injury or illness contracted while on the job. However, some workers in California are exempt from WC insurance, including the following:

  • Independent contractors
  • Those working for aid or sustenance
  • Volunteers
  • Those working for their family members
  • Those working for less than $100
  • Certain municipal appointees
  • Non-profit volunteers
  • Those working for 52 hours or less

 

If you’re not sure if you qualify for WC benefits, make sure and speak to an attorney as soon as possible after your injury.

What Types of Benefits Are Available?

WC Insurance provides several different types of benefits, such as:

Temporary disability benefits. These are benefits paid to workers that have been injured or contracted a work-related illness and can’t return to work for a time or perform the same duties they performed before the injury or disease. Temporary disability benefits are usually paid out every two weeks and stop when you’re able to return to work. They are based on your gross wages, tips, bonuses, commissions, food, lodging, or overtime pay prior to the accident.

Medical benefits. WC Insurance can pay for any treatment that is reasonably required to alleviate the effects of a work-related illness or injury. If you have not predesignated your chosen doctor, your claims administrator will choose a physician from either an MPN (medical provider network) or HCO (health care organization) approved by the California Division of Workers’ Compensation.

Permanent disability benefits. These are benefits paid to employees with a lasting disability that affects their ability to earn a living. Even if you can return to work, if your injury or illness has lasting effects, you may be eligible for permanent disability benefits. These benefits are limited. The amount you may receive is calculated with a formula that includes your age, occupation, date of injury, and relative impairment level.

Supplemental Job Displacement Benefits. These benefits are paid to workers who can never return to the same job they had before the work-related injury or illness. If your employer is unable to provide work that you can perform with the limitations that resulted from your injuries, you may be able to claim SJDB and disability benefits. They are paid out in a voucher, which can be redeemed for re-training, schooling, licensing, certifications, new equipment, tools, or vocational counseling.

Return-to-Work Supplement ProgramThis is a one-time payment of $5,000 made to some recipients of Supplemental Job Displacement Benefits that is intended to supplement lost wages due to the injury or illness.

Death benefits. These benefits are paid to family and spouses of workers that die from a work-related injury or illness. They can cover funeral and burial expenses up to $10,000. The number of dependents determines the amount.

Life pension. This is an amount paid to some recipients of permanent disability benefits after those benefits expire. If you reach maximum medical improvement and are still 70-90% disabled, you may be eligible for a life pension.

Compensable consequences. If your work-related injury or illness leads to another injury, you may be eligible for payments due to compensable consequences. For instance, if you injure your hand while working construction and that hand injury causes you to be unable to firmly grasp objects leading to you spill hot liquid and burn yourself several years later, you may be eligible for compensable consequence benefits.

Steps to Take if You Are Injured at Work

Here are some helpful steps to take to protect your rights and start the WC process after a workplace injury:

  1. Advise your employer. Let your employer know, in writing if possible, that you’ve been injured or have a work-related illness. This step is crucial in starting the WC process. If you don’t report your injury or illness within 30 days, you may lose eligibility for benefits.
  2. Get medical attention. If needed, get emergency medical help. If you have not predesignated a physician, your employer may advise you where to go for treatment. Let the physician that treats you know the injury or illness is work-related.
  3. Fill out a claim form. The law requires your employer to provide you with a WC claim form within one business day of being notified of the injury or illness. You can also find it here. Fill out the employee section and return the form to your employer.
  4. Get an attorney. Retain legal counsel to assist with your claim. Don’t sign anything from the insurance company until you’ve had it reviewed by an attorney.

Workplace Injury Statistics

Here are some statistics and data regarding workplace injuries in California:

  • There were 451 fatal occupational injuries in California in 2019.
  • The majority of fatal occupational injuries in California were due to transportation
  • There were over 483,000 nonfatal occupational injuries or illnesses reported in California in 2019.
  • The majority of these injuries were in the service industries, mainly trade, transportation and utilities.
  • Slips and falls made up almost one-quarter of workplace-related fatalities in California in 2017.

 

Why Do I Need a Lawyer for My Workers’ Compensation Claim?

Suppose your work injury was slight and didn’t result in any missed time at work, or your employer fully accepts that the injury was work-related and agrees to pay for treatment and benefits. In this case, you may not need to hire an attorney, but there are many situations where an attorney is necessary.

Bear in mind, private insurance companies control WC policies and will look for any reason to deny a claim. An experienced attorney will take the lead on dealing with claims administrators that seek to minimize your injuries or deny benefits and make sure you get the full amount owed to you. If there is any disagreement about the severity of your injury or the amount of benefits you may receive, your OnderLaw attorney will act as your advocate and protect your rights while we negotiate a fair settlement.

An attorney can also assist if your employer attempts to retaliate against you because you applied for benefits. It is illegal for your employer to discriminate against you in any way for filing a claim, including cutting hours or pay, demoting you, or firing you.

If you intend to file for Social Security benefits as well as WC benefits, an attorney can help structure your settlement in a way that will not interfere with SSD benefit payments.

Although employers are required by law to carry WC insurance, if you find your employer has broken the law, your attorney can assist you in filing a civil suit against your employer for lost wages or pain and suffering.

How OnderLaw Can Help

Since 2002, OnderLaw has been helping injured workers get the compensation they deserve for their workplace injuries and illnesses. We are intimately familiar with the WC claims process and the ins and outs of applying for benefits. We’re not afraid of the big insurance companies, and we know how to make the law work for our clients.

We know that not everyone can afford a lawyer to assist with their WC claim, which is why we work on contingency at OnderLaw . We take payment for our services out of any settlement or award we obtain for you. There are no up-front costs to our clients.

Our results speak for themselves. Our clients choose us because we’ve successfully obtained over $3.5 billion in settlements and awards in the last twenty years.

Call OnderLaw Today

If you’ve suffered a workplace injury or illness, don’t delay any longer. Talk to the attorneys at OnderLaw today. You only have thirty days from the date of the injury to apply for benefits, so time is a factor. Call for a free, no-obligation, confidential consultation and let us review your case. The consultation is absolutely free, and there are no up-front fees, so don’t wait. Call OnderLaw today.