Workers’ compensation lawyers in California help injured employees obtain benefits for work-related injuries. By offering advice, gathering facts, negotiating with claims administrators, and presenting evidence to workers’ compensation judges, workers’ compensation lawyers help injured employees maximize the benefits that are available under California’s workers’ compensation scheme.
What Is Workers’ Compensation?
Every state has workers’ compensation laws. The federal government also has a laws that provide workers’ compensation benefits to federal workers who are injured at work.
Workers’ compensation is a form of employer-provided insurance that guarantees benefits to employees who are injured at work. California’s workers’ compensation scheme is designed to help injured workers avoid financial problems (such as losing their homes) if they are unable to work because of an injury. Workers’ compensation benefits provide partial income replacement while the injured worker is recovering from an injury, as well as financial compensation for disabilities that will permanently impair an injured worker’s health or future earning capacity.
California’s workers’ compensation scheme does not require injured workers to prove that anyone was at fault in causing the injury. Unlike personal injury cases, which require proof that the negligence of another caused them injury, workers’ compensation benefits are available regardless of fault. With rare exceptions (such as an injury caused by a fight that the injured worker started), benefits are available even if the injured worker’s own carelessness contributed to a work injury.
In exchange for the making workers’ compensation benefits available regardless of fault, the benefits are usually more limited than a personal injury victim might receive. However, workers’ compensation cases tend to resolve more quickly than personal injury cases, because benefits are determined by an administrative process that is designed to resolve claims soon after the full extent of an injury is understood.
What Are Workers’ Compensation Benefits?
The California’s workers’ compensation system provides benefits to employees who suffer a work-related injury. Employers must carry insurance that provides those benefits or must satisfy the state that they are lawfully self-insured.
Employers must provide medical treatment for work-related injuries that require more medical attention than first aide. Employers must also provide temporary disability benefits which replace some of an employee’s income while he cannot work full time and is recovering from a work injury.
Injured workers who suffer permanent impairment that is caused by a work injury are entitled to permanent disability benefits. Since workers’ compensation claims administrators often resist paying the full benefit that the law allows, injured workers often seek help from a California workers’ compensation lawyer when their injury is unlikely to heal fully.
Injured workers who are unable to resume their employment may also be eligible for a benefit that will pay for job retraining and certain other expenses (such as tools or a computer purchase) that may help the worker reenter the work force.
Finally, certain dependents are entitled to death benefits if an employee dies because of a work-related injury or health condition. The amount of the death benefit a dependent will receive depends on several factors, including the dependent’s age and relationship to the deceased worker, the total number of dependents, and the extent to which the dependent relied upon the deceased worker for support.
What Is a Workers’ Compensation Lawyer?
A workers’ compensation lawyer is a licensed attorney who handles workers’ compensation cases. Since workers’ compensation is a very complex field of law, many workers’ compensation lawyers limit their practice to workers’ compensation cases and to closely related areas of law, such as social security disability claims.
California’s workers’ compensation system is described in the California Constitution and in California statutes. Many of the details, however, are found in administrative regulations and in publications of the California Department of Industrial Relations that workers’ compensation judges consult when they decide cases.
Since workers’ compensation law depends so heavily on statutes and administrative rules, a workers’ compensation attorney must analyze the law in great detail in order to represent clients effectively. A lawyer who dabbles in workers’ compensation cases might not understand the nuances of the law that help injured workers maximize their recovery.
What Do Workers’ Compensation Lawyers Do?
Workers’ compensation lawyers advise clients who have suffered a work-related injury about their rights. They ask questions to determine how an injury was caused. When the facts surrounding a work injury are disputed, the lawyer’s team may conduct an investigation by interviewing witnesses and collecting important evidence.
Workers’ compensation attorneys also review medical evidence to determine the extent of an injured worker’s disability. They review reports written by physicians to assure their accuracy and may help injured workers correct any facts that the physician may have gotten wrong. When patients dispute a treating physician’s assessment of an impairment, lawyers advise patients about procedures they can follow to obtain a second or third opinion.
When a claims administrator has taken an unreasonable position, workers’ compensation lawyers fight to maximize the benefits that injured workers receive. In most cases, a workers’ compensation attorney will negotiate a settlement. When a claims administrator continues to take an unreasonable position, however, the lawyer will represent the injured worker at a hearing before a workers’ compensation judge. In some cases, it may also become necessary to represent the injured worker in an appeal to a California appellate court.
Do I Need a Workers’ Compensation Lawyer?
When a work injury requires treatment that the employer willingly provides and the injured worker misses no more than a day or two of work, he probably will not need a workers’ compensation lawyer. As long as there is no dispute about medical treatment and no need for temporary disability benefits, there is usually no need to hire a lawyer.
When an injured worker misses more than three days of work, he is usually entitled to temporary disability benefits while recovering from the injury. As long as the claims administrator pays those benefits and calculates them correctly, there is probably no need at that stage to get help from a workers’ compensation lawyer. If the injured worker returns to work and has no permanent disability, he will probably receive all the benefits that the law provides without seeking help from a lawyer.
In other circumstances, an injured worker may need a workers’ compensation lawyer. Examples of those circumstances include:
- The claims administrator disputes that the injury is work-related
- The claims administrator disputes that a health condition was caused by work
- The claims administrator will not agree to pay for medical treatment that the injured worker requires
- The claims administrator has not considered all wages that the injured worker earns from all jobs when computing the temporary disability benefit
- The claims administrator disputes that the injured worker has a permanent disability
- The claims administrator and the injured worker disagree about the extent of the permanent disability
- The claims administrator and the injured worker disagree about how much of the injury was caused by work and how much was caused by other activities
- The claims administrator and the injured worker disagree whether the he can return to work
- The employer refuses to respect work restrictions imposed by the treating physician
- Stipulated Findings and Award — the injured worker and the claims adjuster agree about all the facts, and a workers’ compensation judge enters an appropriate award of benefits that are generally paid over a period of time. In addition, the injured worker retains her right to ongoing medical care at the expense of the insurance company.
- Compromise and Release — the injured worker and the claims adjuster agree upon a lump sum payment that will release the insurance company from making any additional payments for permanent disability or medical care in the future.