Los Angeles Work Injury Lawyer
Los Angeles Work Injury Attorney
Getting injured at work in Los Angeles, CA can be stressful. You know that you are supposed to be compensated for what happened but, too often, it can be a struggle to understand if or when you are going to receive what you’re owed. The initial process of getting a claim to insurance can be easier to handle, but when they come back saying that they want to give you less than you’re owed or outright reject your claim, the maze of the appeals process begins.
You need a talented, seasoned Los Angeles work injury lawyer to help you through the process and to throw their ability behind your case. With the right legal help, you can significantly improve your chances of getting what’s supposed to be coming to you. At Diefer Law Group, we understand the way the process works and the tricks that the insurance companies use. We can set you up with a solid argument for what you’re owed.
California Work Injuries
Not every injury at work will qualify for workers’ compensation. The law in California creates some stipulations around what can be considered a work injury. Of course, there are also some injuries that aren’t clearly within or outside the criteria set forth by the law. That’s where consulting with a lawyer can be particularly helpful, as they can help determine if you have a case or not with your specific injury.
Generally, the defining criteria for a work injury is that it must “arise out of employment” and “in the course of employment.” Put simply, this means that the injury happened while you were at work and performing your job duties. Being at work does not include your commute to start your shift or after it. However, often traveling during your workday to a job site or meeting may be considered as being at work. You must also be performing the functions of your job as expected under your employment agreement. This means that injuries may not be covered if they were a product of things like “horseplay,” intoxication, or self-harm.
What Workers’ Comp Covers
It’s unlikely that most employers have the funds in reserve to cover all the possible costs associated with a workplace injury. They couldn’t be counted on to use those funds even if they did. Therefore, California Law requires businesses to carry workers’ compensation insurance policies. This ensures that employees are protected in the case of an injury.
The exact details of what workers’ compensation will cover are dependent upon the severity of each injury and the time necessary for recovery if a full recovery is even possible. In general, though, workers’ compensation should cover all medical expenses associated with the treatment of your injury, so long as you work within the provider network of the insurance company. It can also include disability payments that generally will be about two-thirds of your normal weekly wages, up to a maximum amount that is set by the state and updated yearly. If the injury is so significant that it requires a career change, then training and job placement services may also be covered by workers’ compensation. It is also possible that, if the injury results in death, qualified family members may be able to receive death benefits covering things like funeral costs and lost wages. It’s a good idea to speak with a lawyer to see that you are getting everything that you should.
Workers’ Comp Duration
The duration of workers’ comp is dependent on the nature of the work injury. Workers’ comp should cover the entirety of the cost of treatment for the injury, no matter the duration. The temporary disability benefits will run until:
- You return to work.
- A doctor clears you to return to work.
- You have received a total of 104 weeks of disability pay.
The 104 weeks is generally the maximum for temporary disability, but you may receive less if the injury is less severe. There is also a 240-week maximum for those whose injury involved:
- Amputation
- High-velocity eye injury
- Chemical burns to the eyes
- Severe burns
- Chronic lung disease
- Pulmonary fibrosis
- Acute and chronic Hepatitis B
- Acute and chronic Hepatitis C
- HIV
Both the 104 weeks or fewer and 240 weeks or fewer do not need to be taken consecutively. However, they must be taken within five years of the accident that caused the injury. If the temporary disability runs out, you may seek a permanent arrangement if the injury is something you might never fully recover from.
Long-term disability claims will likely result from a legal process, and they can be worked out through a mandatory settlement conference requested by the insurance companies. It’s generally the preference of the courts that the agreement be worked out in these conferences. There are alternative methods, though a judge is unlikely to allow them unless there is a demonstrated good cause for moving on to an alternative. Having a strong workers’ compensation lawyer like those with Diefer Law Group can help these conferences go in your favor. Our experience in handling settlements is vital to your receiving one that will address all your needs. Settlements will typically take one of two forms: stipulation and award or compromise and release.
Stipulation and Award
In a stipulation and award settlement, you and the insurance company must agree on the details of the financial payments and not just the overall value of the award. However, the medical costs to care for your injury do not need to be included, as the insurance company will continue to pay for that treatment. Additionally, under a stipulation and award agreement, you may continue to work for your employer on whatever basis you are able. Additionally, if your condition takes a turn for the worse, you are able to reopen the case under this kind of agreement.
Compromise and Release
A compromise and release settlement is a sort of full closing of the case. After the settlement is reached:
- Your employment will be terminated.
- You will be responsible for your own medical treatment.
- You will not be able to reopen the case if your condition worsens.
In exchange for all of this, you receive a lump-sum payout that is agreed upon between you and the insurance company. It is unlike the stipulation and award, where the details of what the award is covering must be agreed upon. In a compromise and release settlement, only the total value of the lump-sum payout needs to be agreed to by both parties.
When You’re Injured
When you have a work injury, there is a strict procedure for how it should be handled. It’s important to follow this procedure because the law generally requires that workers’ comp claims be settled quickly. Get in contact with us at Diefer Law Group early in the process and especially before you accept any terms. We can help you make sure that you are following proper procedures and receiving the benefits you deserve. When you are injured at work, the general procedure to follow is:
- 30 Days – Your employer must be notified of the injury within 30 days of its occurrence.
- Medical Treatment – You must seek treatment from a doctor that is approved by your employers’ workers’ comp provider. Your employer should be able to direct you as to where to go.
- DW1-C – This is a claim form that your employer will provide to you. On it, you will be asked to describe the nature of both the injury and the incident that caused the injury. Return the completed form to your employer as quickly as possible.
- Submission – Your employer will submit the completed DW1-C form, along with anything required on their end, to their workers’ comp insurance provider.
- 90 Days – You should hear an answer back on your claim within 90 days of its submission.
- Appeal – If your claim is denied, or if there is some element of it that is in dispute, you may begin the process of appealing their decision. This is when it is especially important to have a lawyer involved because the appeals process can be complex and challenging to navigate. A lawyer’s experience and knowledge of these situations can prove invaluable.
Work Injury Lawyer FAQs
Q: What Is Considered a “Work Injury?”
A: In Los Angeles, California, there are two requirements for a work injury that make it eligible for workers’ compensation. They are that the injury must:
- Arise out of employment
- Occur in the course of employment
Put more simply, this means that the injury must happen while you’re at work and be a product of your performing the job that you’re hired to do. You are not considered to be at work during your commute. However, if you have to travel to a job site or a meeting, that may be considered as being at work. The injury also must occur while you are doing something that is considered a function of your job. This also includes tasks that you may be asked to perform that are outside your normal job duties. Some of the injuries that might be considered as being outside of these parameters are those that:
- Happen during a lunch break
- Involved the injured employee being intoxicated
- Was the result of ‘horseplay’
- Occurred during the employee’s commute
- Was intentionally caused by the employee
Q: Will Workers’ Comp Benefits Last Until I Can Work Again?
A: Workers’ comp benefits should last for the duration of your injury. If your injury is something that you may never fully recover from, there are permanent disability options to cover that. In most cases, where recovery is likely, temporary disability workers’ comp benefits last for a maximum of 104 weeks. However, that timeframe may be less if you are able, or cleared by a doctor, to return to work sooner. There is the possibility of up to 240 weeks if your injury is one of a few particular injuries. The weeks of disability do not necessarily have to be taken consecutively if you are able to return to work sporadically, but they must be used within a span of 5 years.
Q: Will I Receive My Full Wages With Workers’ Comp?
A: Not typically. Your missed wages are covered under the disability portion of workers’ comp. These are usually around two-thirds of your normal, weekly wages, but they must be under a maximum weekly amount set by the state. Wages, though, are only part of what workers’ comp covers. Your medical treatments are also paid for through workers’ comp, although you will have to go to an approved doctor. Additionally, if the injury is going to require you to change careers, then some training and job placement services may be covered.
Q: What Happens After I Get Injured at Work?
A: Managing workplace injuries and getting the restitution you’re owed require following a very particular process. If your employer is unaware of the injury, you must make sure to tell them within 30 days. After that, they will advise you on where you can get treatment within their workers’ comp insurance providers network. You will also be given a DWC-1 claim form, on which you will be asked to describe the details of the injury and the circumstances under which you received the injury.
After you return the form, your employer will send it to the insurance company. They will have 90 days to give you a reply, and if they fail to do so within 90 days, the claim will default in your favor. You should wait until you’ve had a chance to talk with a Diefer Law Group lawyer before you sign anything so you can be sure that you’re receiving everything you’re owed. If you have a dispute or are rejected, we may be able to help you file a claim to appeal for what you should be receiving.
Don’t Miss Out on Getting What You Deserve
If you have a work injury, then you likely qualify for workers’ compensation. However, that doesn’t necessarily mean that it is going to come easily. Whatever is paid out to you will come straight off the bottom line for an insurance company. They aren’t eager to see their profits eaten into. Unfortunately, the more significant the injury, the harder they fight to avoid paying what they should because the payout is greater. To make sure that you get what you’re rightfully owed, you need a team willing to fight by your side. At Diefer Law Group, we are ready to be that team. We have the experience and skill to help you pursue every avenue to get what you’re owed. Contact us today so we can take a look at your case.
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