Irvine Work Injury Lawyer

Q: What Happens If I Get Injured at Work?

A: If you’re hurt at work, you will want to make sure to act quickly. The law doesn’t leave a lot of time for legal action to be taken, so promptly addressing the situation is important. There are a few steps involved in the process, which are:

• Notify your employer of the injury within 30 days.
• Your employer will send you to get treatment at a provider that is approved by your employer’s workers’ comp insurance company.
• Your employer will provide you with a DWC-1 claim form to fill out. You must provide a description of the injury that you suffered and the circumstances that created the injury.
• When you give your employer the form, they will send it to the insurance agent.
• You should hear back within 90 days.
• If your claim is rejected or there is a dispute, you can appeal. It would be a good idea to speak with a lawyer before this point, but you will definitely want to review your options with one if you haven’t before this.

Q: What’s the 90-Day Rule for Workers’ Comp in California?

A: When a claim is submitted to a workers’ compensation insurance company in California, they then have no more than 90 days to respond. If they fail to respond within 90 days, there is a default liability decision, and your claim should be paid out. It is possible to overturn this decision, but that is very rare. The only way that can happen is if there is new evidence regarding the claim that meets three criteria:

• The evidence must be materially relevant to the claim in question.
• The evidence cannot be something that your employer or the insurance company was aware of in the 90 days after submission.
• The evidence cannot be something that your employer or the insurance company could have discovered during that time.

Q: What Is a Work Injury?

A: There may be injuries at work that don’t qualify as work injuries. For instance, injuries that are a product of intoxication or intent on the part of the injured won’t be covered by workers’ comp. Additionally, an injury that happens on the way to or from work is also unlikely to be covered. This is because they don’t meet California criteria that require a work injury to “arise out of employment” and occur in the “course of employment.” This means that, for something to qualify as a work injury, it must occur while you are at work performing a function that is a part of your employment. Something like “horseplay,” which is not work that you were hired to do, leading to an injury will not likely be covered. If you are unsure whether your case qualifies as a work injury or not, it can be helpful to talk with a work injury lawyer.

Q: How Much Missed Work Will Workers’ Comp Cover?

A: Workers’ comp will always cover the medical costs associated with your injury. Missed wages during your time out of work will be covered by either a temporary or permanent disability program, depending on the severity of the injury. In most cases, the disability will end when you are able to return to work or a doctor clears you for work. While temporary disability has a maximum of 104 weeks available, it may often run for a shorter period of time. There is a possibility of 240 weeks on temporary disability if you were afflicted with one of a few specific injuries. 

In either case, there is no requirement that weeks be used consecutively. That way, if you attempt to return to work but find that your condition worsens, you can take more time off. However, the weeks must be used within five years. For those with injuries so severe that temporary disability is not enough, permanent disability may be an option.