A Santa Rosa workers’ comp lawyer can help injured employees receive the insurance benefits they deserve
With few exceptions, every California business which has employees is required to maintain workers compensation insurance for its employees. That insurance pays benefits to employees for work-related injuries. When a workers compensation insurance company resists paying the benefits to which an injured worker is entitled, a Santa Rosa workers’ compensation lawyer can help.
Workers Compensation Insurance Coverage
Workmans comp insurance covers job-related injuries and diseases. An injury is job-related if it arises from work, and if it occurs in the course of work. With few exceptions, injuries sustained in the workplace during working hours are likely to be covered.
Even injuries occurring outside the workplace are covered if they are work-related. For example, an employee who is asked to pick up supplies from an office supply store is covered if the employee is in a traffic accident while traveling to or from the store.
Work injuries are covered without regard to fault. Injured workers’ are not required to prove that their employer’s negligence caused the injury. Even if the injury was caused by the employee’s own carelessness, it will be covered.
Diseases and injuries that occur over time are also covered if they are work-related. Pulmonary fibrosis is an example of a disease that is covered by workers’ compensation insurance, if it is caused by prolonged workplace exposure to metal fibers, wood dust, or other harmful substances in the workplace. Injuries that occur over time include such things as hearing loss and certain repetitive stress/motion injuries.
Sometimes coverage is clear and will not be disputed. In other cases, a workers’ compensation insurance company may argue that the injury did not occur at work, or that the disease was caused by environmental factors outside the workplace. When coverage is disputed, a Santa Rosa workers’ compensation lawyer can help injured workers fight for the benefits to which they are entitled.
Workers Compensation Insurance Benefits
The primary workers’ compensation benefits include payment of medical expenses, replacement of lost income, and money as compensation when the effects of the injury or disease will be permanent.
Medical expenses for work-related injuries are covered when treatment is provided by the doctor or clinic designated by the employer or its workers’ compensation insurance company.
Temporary disability benefits are paid at the rate of 2/3 of one’s average weekly wages, subject to minimum and maximum payments. The payments are not taxed. An injured worker is entitled to temporary disability benefits after missing three or more days of work due to a work injury.
Permanent disability payments are paid after an injured worker reaches a point of maximum healing but only if she does not make a full recovery. The amount of the permanent disability benefit depends upon the extent of the permanent disability. Since that determination is subject to dispute, insurance companies often try to pay less than what injured workers are entitled to. A Santa Rosa workers’ compensation insurance lawyer can help injured workers obtain the benefits they are entitled to.
Making a Workers Compensation Insurance Claim
Making a workers’ comp claim starts by first notifying the employer of the injury. Reporting the injury should be done as soon as possible.
The employer must give the injured worker a workers’ compensation claim form within one working day after the injury is reported. The injured worker should complete the form and return it to the employer promptly. The employer then submits the form to the employer’s workers’ compensation insurance company, which assigns a claims administrator to handle it. The claims administrator’s job is to manage the medical care and disability benefits the injured worker is entitled to as a result of the work injury.
Disputes arise when the claims administrator alleges that the injury or disease is not work related, or contends that the injured worker may be malingering and should return to work against a physician’s advice. Disputes are even more likely to occur when computing the amount of permanent disability benefits. In those circumstances, an injured worker should receive guidance from a Santa Rosa workers’ compensation lawyer.
Failure to Maintain Workers Compensation Insurance
Employers generally cover every employee with workers’ compensation insurance. If they fail to do so, they may face serious criminal penalties. In addition, the injured worker may, in some circumstances, seek damages in a lawsuit against the employer that would not be available as a workers’ compensation benefit. For that reason, most California employers are careful to keep their workers’ compensation insurance in effect at all times.
Santa Rosa Workers Compensation Lawyers
When a workers’ compensation insurance company fails to pay the benefits to which an injured worker is entitled, a workers’ compensation attorney in Santa Rosa can help. To make an appointment with an experienced workers’ comp lawyer, call Kneisler & Schondel at (707) 542-5132. You can also ask a question by submitting our online contact form.