Riverside Work Injury Lawyer
Riverside Work Injury Attorney
When you’re injured as a result of your work, you’re owed some kind of compensation for any time that you may miss at work. You shouldn’t be responsible for the medical bills associated with it, either. Workers’ compensation exists for those reasons. Your Riverside, California, employer is required to carry workers’ compensation insurance just in case something like a work injury happens. Unfortunately, though, you might meet some resistance when you try to get what you’re owed. That’s where work injury lawyers like those at Diefer Law Group can help. We have experience dealing with workers’ comp claims and can help you seek what you deserve.
What Constitutes Work Injuries?
For an injury to be considered a work injury that is eligible for workers’ compensation, it must meet California’s legal criteria. This says that the injury must “arise out of employment” and occur in the “course of employment.” This means that the injury must occur while you were at work performing the functions of your job. Therefore, an injury that occurred during your commute to and from work is probably not eligible for workers’ comp. Similarly, if the injury were to be a product of non-work-related activity at work, such as “horseplay,” intentional harm on the part of the employee, or the employee being intoxicated, it may be ineligible for workers’ comp coverage. When you speak with a Diefer Law Group representative, they may be able to help you understand whether your injury may qualify for workers’ comp.
Workers’ Comp Coverage
Businesses in California are required to carry workers’ compensation coverage so that employees have some measure of protection from the costs associated with a workplace injury. The specifics of what the workers’ comp will cover are dependent upon the nature of the injury and the prospects for recovery. Workers’ comp may cover things like:
- All the medical treatment related to your injury can be paid through your settlement.
- A portion of wages is covered through a disability program. This may be temporary or permanent, depending upon the injury sustained.
- The cost of training and job placement services will be covered if the injury is going to require you to change careers.
- Funeral benefits are available to qualifying family members if the injury took the life of an employee.
The wages in the disability program are not your full amount. Typically, they are around two-thirds of your normal weekly wages, so long as that doesn’t exceed a maximum value that is set by the state, which is updated regularly.
The Duration of Workers’ Comp
The duration of workers’ comp should be decided based on the kind of injury and the recovery that is expected. In the majority of cases, a temporary disability program will be enough. If the injury is fairly mild, this disability could run only a few days, although there is a maximum of 104 weeks available. If you are able to work again, or a doctor has cleared you to return to work, then your disability may come to an end. However, if your condition worsens, it can be restarted. The weeks available with temporary disability can be used sporadically instead of consecutively, but they must be used within five years of the injury. Temporary disability could be extended to 240 weeks if you have one of a few conditions that are spelled out by the law.
Permanent disability may be available to those who may never fully recover from their injury. These cases are typically sent to a mandatory settlement conference, where it is the court’s preference that a settlement be reached. A judge must be persuaded that there is good cause to make use of any other method. The kind of settlement usually comes in one of two forms:
- Stipulation and Award – This is an agreement that allows for a negotiated award with the exact components of the award stipulated. Under this settlement, the workers’ comp provider continues to cover all medical treatments related to the injury. You are also allowed to continue to work with the same employer in whatever fashion will work for your injury. Lastly, the case can be reopened if you find that the condition of your injury deteriorates.
- Compromise and Release – This kind of agreement is designed to bring your workers’ comp case to a close. You and the workers’ comp provider must come to an agreement on a total lump-sum value for the injury. This does not have to stipulate the components that lead to that valuation. You merely must agree on a total value. In exchange for that lump-sum payment, your employment is terminated, your future medical bills become your responsibility, and the case cannot be opened again, even if your condition worsens.
Workers' Compensation Laws FAQs
Q: What Is California’s 90-Day Rule for Workers’ Compensation?
A: Once a claim is submitted to the workers’ comp insurance provider, according to California law, they have 90 days to respond to the claim. If they do not respond within 90 days, then there is “default liability,” meaning that the claim will be considered as not rejected and must be paid out. While it is difficult to overturn the 90-day rule, there is one exception for new evidence. However, this new evidence must meet three criteria:
- It must be something that your employer didn’t know and the insurance agent didn’t know.
- It must be something that your employer and the insurance couldn’t have discovered if they had tried to find it.
- It must be something that is materially relevant to the accident or injury in question.
Q: Is My Injury a Work Injury?
A: For your injury to be considered a work injury, it must meet the criteria of being something that occurred in the “course of employment” and “arose out of employment.” This is a way of saying that the injury must be something that occurred while you were at work and was a product of your performing the functions which you are employed to do. This means that, if you were not technically ‘at work,’ such as when you are commuting or on a lunch break, it’s possible that the injury may not be covered. Similarly, if you were doing something at work other than your normal job functions, then you may not receive workers’ comp. Some of the things that may disqualify a workers’ comp claim include injuries that:
- Were the result of “horseplay”
- Were caused by the employee’s intoxication
- Occurred during a lunch break
- Occurred during a commute to and from work
- Were intentionally caused by the employee
Q: How Long Will My Workers’ Comp Last?
A: Workers’ comp may last just a few days or cover the rest of your life. What determines the length of the benefits is the severity of the injury and what you are able to require of the insurance company. For injuries from which you will never fully recover, the possibility of permanent disability exists. For most injuries, though, temporary disability will be enough. The maximum number of weeks available for temporary disability in almost all cases is 104, although it is typically much less if you are able to work sooner or are cleared by a doctor to do so. The weeks provided with temporary leave are not required to be used consecutively, as you may be able to return to work for short periods, depending on the recovery process for your injury. However, the weeks must be used within five years of the original injury. There is also a temporary disability that extends to 240 weeks if you have one of the following injuries:
- Severe burns
- Chemical burns to the eyes
- High-velocity eye injuries
- Amputation
- Chronic lung disease
- Pulmonary fibrosis
- HIV
- Acute and chronic Hepatitis B or C
Q: What Do I Do If I Get Injured at Work?
A: If you’re injured at work, the law doesn’t leave a lot of time for taking action. You will need to notify your employer within 30 days. To get treatment covered through workers’ comp, you will need to go to a provider that is affiliated with your employer’s workers’ comp insurance policy. Your employer should give you that information. They should also provide you with a DWC-1 claim form that you must fill out and return to them. They will then provide that information to the insurance company, which should give you an answer within 90 days. If your claim is rejected or there is a dispute, then you can appeal the decision. It can be valuable to work with a lawyer during this process, as they can help ensure that you get the entirety of what you’re owed.
Don’t Take on the Workers’ Comp Providers Alone
When you’re injured at work and seeking workers’ comp, you’re asking an insurance company to take money from their bottom line and give it to you. Naturally, it shouldn’t be any real surprise that they are often hesitant to hand over the entirety of what you should receive. Often, getting what you’re owed is going to require some level of fighting against someone who wants to limit what you receive. At Diefer Law Group, we are ready to represent you and fight for you. It’s a fight we’ve made before and won. Contact us to take a look at your case.
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