Sustaining an injury at your Orange County place of employment can be a scary and uncertain event. You may not know what legal options are available to you and feel overwhelmed as the medical bills start flowing in, even as you are unable to return to work due to the harm you have suffered. You might begin to wonder, what happens when you file a workers’ comp claim in Orange County? Thankfully, an experienced attorney can help answer that question.
The claims process for workers’ compensation coverage can be complex and time-consuming. The legalities involved can also be taxing, especially for individuals who need rest to heal and recover from their workplace injuries. However, the benefits you could receive are paramount to the ability to recover in a way that does not inflict hardship on your personal finances. Allow the attorneys at Diefer Law Group to guide you through this process.
What Is Workers’ Comp in Orange County, California?
In the state of California, all employers are required to carry workers’ compensation insurance. This means that if you are injured on the job through no fault of your own in Orange County, CA, you have the right to file a claim for benefits to help you recover from these injuries and not suffer negative effects such as lost wages. Benefits available under California workers’ comp can include:
- Medical Benefits: Often, workers’ comp will cover the costs of your necessary medical treatments and expenses. This can include costs for emergency services, medications, surgeries or procedures, and any ongoing treatment or follow-up care.
- Rehab Benefits: You may also become eligible to receive benefits for new vocational training, physical therapy, and any other rehabilitation means that become necessary to help you return to work.
- Disability Benefits: If your injury causes you to miss work, be it permanently or temporarily, you may be able to recover lost wages.
- Death Benefits: If you have lost a loved one due to a workplace injury or illness, you could receive benefits that the employee themselves would have qualified for.
How to Apply for Workers’ Comp Following a Work Injury or Illness
If you sustain an injury or become diagnosed with a work-related illness, you have the legal right to apply for benefits through your employer’s workers’ compensation insurance. The filing process will include the following steps:
- Seeking Medical Attention: The most important thing to do if you experience a work-related injury is to seek the necessary medical care you need. This can include any emergency services, surgeries, treatments, or medications.
- Reporting the Injury or Illness: As soon as you are physically capable of doing so, you must inform your employer of your injuries. This should happen no later than a few days following the accident in which you were injured. You should explain in detail the nature of the accident and the subsequent injury.
- Submitting a Claim: You should fill out and return an official claim form to your employer. This should detail the injury and its case. It should be properly filled out with all the correct information included. Your employer will actually submit the claim to their insurance provider.
- Waiting for Claim Review: Your employer’s insurance company will begin a formal review of the claim application and determine its validity. They will determine your eligibility for benefits. Keep in mind that during this process, the insurance company might also reach out to you for additional information.
- Following Up: If your claim is denied, you have the right to appeal this determination. An attorney can assist you in this complicated process.
What Happens After: Delays, Denials, and Appeals
It is important to keep in mind that, following the filing of your workers’ comp claim, you may experience delays and can even face a denial. The most common reasons people experience delays in their workers’ comp claim include:
- Incorrect or incomplete paperwork
- Delays due to medical evaluations
- Being accused of fraud
- Lacking necessary witness statements
- Facing a dispute over the severity or nature of your injury
- Gaps in communication
If you receive a denial or are unsatisfied with the decision of the insurance company, you have the right to file an appeal. To do this, it is wise to bring an attorney on board if you haven’t done so already. Your attorney can:
- File your appeal petition
- Negotiate with the insurance company
- Argue your case in front of a judge
FAQs
Q: How Do I Go About Detailing My Injuries in a Workers’ Comp Claim?
A: It is very important that, in your workers’ compensation claim, you detail your injuries to avoid any possible delays. To do this, you should collect or have your attorney collect any X-rays, MRIs, or other medical images related to your injury, the doctor’s diagnosis of the injury, any medical bills or records, and the relevant testimony of any healthcare professionals.
Q: How Can an Attorney Help Me Deal With a Workers’ Comp Insurance Company?
A: The unfortunate reality is that many insurance companies involved in workers’ compensation cases will not treat your claim with fairness or in a timely manner. Having an attorney on your side can help if this is the case. Your attorney can protect you from certain bad faith actions, such as a denial, a delay, or a lowball offer, and can ensure that the insurance company resolves your claim in a timely manner.
Q: What Work Injuries Are Most Common in California?
A: Suffering a workplace injury can be a frightening experience, and there are several ways that these situations can come about. You may be injured in a slip and fall accident, be struck by an object, or be crushed or pinned by heavy machinery. The most common workplace injuries include broken bones, amputations, electric shock, traumatic brain injuries, spinal cord injuries, soft tissue or organ damage, and repetitive motion injuries.
Q: How Do You Calculate a Workers’ Comp Settlement in California?
A: There are three elements involved in a workers’ comp claim that will be used to calculate the settlement amount. These include the classification rate for the kind of work you were doing, how much the company you work for spends on their payroll, and the risks that were involved in the type of work you were performing.
Speak With an Experienced Workers’ Comp Lawyer Today
If you have been injured at your Orange County place of work, you have the right to seek compensation. The attorneys at Diefer Law Group are here to help. Contact our offices today to schedule your free consultation.
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