Suffering injuries on the job is especially upsetting as you were only trying to earn income to support yourself and your family. An injury on the job can put your life on hold, prevent you from enjoying your personal time and hobbies, and stop you from returning to work.
Fortunately, California requires that nearly all employers have workers’ compensation insurance, and if they do not, there is a state fund available to cover certain costs. Collecting your deserved workers’ compensation benefits in full is critical to your future, but it can be difficult to do on your own. Insurance companies often challenge workers’ comp claims for different reasons, and this can result in the delay or denial of your claim.
The last thing you need after a work-related injury is to worry about the status of your benefits. Having a San Mateo workers’ compensation attorney on your side through each step of the process will ensure that you receive the full benefits the law entitles you to. Read on to learn more about the workers’ compensation process, what coverage you should have, and how an attorney can help.
California Workers’ Compensation Coverage
If you are an employee in the State of California, your employer must carry workers’ compensation insurance, even if they have only one employee. In California, there is a “no-fault” system in place, which means that you have a guarantee of coverage for your workplace injury no matter what caused it.
This is a trade-off with the employer, as you also lose the right to sue your employer or recover the non-economic damages associated with your injury.
Workers’ compensation benefits cover limited losses, including:
- Medical treatment – You should not have to pay for any expenses relating to the current or future treatment of your work-related injuries.
- Wage replacement – If your injury prevents you from working, whether for one day or several months, your benefits should replace a percentage of the wages you lost.
- Disability – If your injury resulted in a temporary or permanent partial or total disability, you can recoup benefits for your lost earning ability.
- Death benefits – In the tragic event that a family member dies from a work-related injury or illness, spouses or children can seek death benefits.
These benefits are valuable when you recover from an injury, but they do not include pain and suffering or intangible losses like a personal injury claim can. Discuss your options with your workers’ compensation lawyer, who can determine whether a third-party claim is also possible in your case.
Common Workplace Accidents and Injuries
While industries such as construction are more inherently dangerous than others, people can slip and fall in an office building or sustain similar injuries at almost any type of job.
Common accidents and injuries that often lead to workers’ comp claims include:
- Falls from high places
- Getting hit by falling objects
- Vehicle and transportation accidents
- Equipment or power tool accidents
- Explosions or fires
- Chemical exposure
- Repetitive strain injuries
- Respiratory illnesses
- Hearing or vision loss
Your first order of business after any type of accident should be to get the medical diagnosis and treatment you need.
While your employer should have coverage, you still must apply for your workers’ compensation insurance benefits, as they will not happen automatically.
You will need evidence to show:
- Your injury or illness stemmed from the course of your employment
- The nature of the medical treatment recommended
- That your injury necessarily prevented you from working (if applicable)
Your claim may not be accepted initially, as denials are more common than you might think. If the insurance company denies your claim, you will need to follow appeal procedures, and this will delay your benefits. Having an attorney on your side can improve your chances of having the evidence you need for a successful initial claim.
Reasons to Hire a San Mateo Workers’ Compensation Attorney
Like any for-profit company, insurance companies have the primary goal of maximizing revenue and minimizing costs. Insurance companies generate revenue by collecting premiums from their customers and minimize costs by paying as little as possible to claimants, which can include workers’ compensation claims.
Insurance companies can challenge your claim in different ways, such as:
- Stating your injury was pre-existing
- Stating your medical condition was not work-related
- Questioning the extent of your injuries and whether you can return to work
These companies have adjusters and investigators who will search for any indication that your claim is not valid. This often results in claim denials. Deadlines are quick, so if you receive a denial, your first call should be to a workers’ compensation lawyer who can begin the appeal process right away.
In some cases, you might receive benefits right away, but then the insurance company terminates your benefits or denies medical coverage down the line. An attorney can help in this situation as well, as we can fight for the insurance company to reinstate your full benefits.
If your work-related injury led to a long-term disability, the insurer might want to avoid paying monthly benefits for the rest of your working life. The adjuster might offer a settlement, which is a one-time lump-sum payment in lieu of continuing benefits. A settlement offer might seem extensive at first, but they are often inadequate, and you should never accept any offer without first speaking with an experienced attorney.
Our lawyers can assess whether the settlement is fair, given your future medical needs and other factors. If you accept too low of a settlement, you cannot later reopen the claim, so you need the right legal guidance.
Contact a San Mateo Workers’ Compensation Attorney for Help
The time to connect with a San Mateo workers’ compensation attorney is as soon as possible after your injury so that you have someone advocating for your best interests before the insurance company challenges your claim. Reach out to Galine, Frye, Fitting & Frangos at (650) 345-8484 for assistance as soon as possible.