Hurt on the Job? A Lawyer Can Provide Legal Assistance for Claims and Appeals

Job-related injuries in Southern California continue to occur at an alarming rate. 

Schools, hospitals, restaurants, and grocery stores can be danger zones for workers who are just trying to do their jobs. The same is true at construction sites, airports, warehouses, and wherever you find first responders. The danger exists even when the best risk management steps are taken. It is not a question of where or why, but how. 

Those who are hurt at work may be unable to return to their job temporarily or permanently, and in most cases will need medical care. The best way for those hurt on the job to receive the full range of benefits they are entitled to is to have an experienced Workers' Compensation attorney on their side. 

In a field that is constantly changing, it is best to have an accomplished lawyer by your side to help guide you in this treacherous time.

What Happens If You Get Injured at Work?

The Workers’ Compensation system was developed to cover a range of work-related injuries and illnesses, in order to give the most and best care to employees.  If you do not know what to do if you have been injured on the job, it is important to talk with a work-related injury attorney.

Below is a list of example accidents and health hazards that our program encompasses.

Work Can Be a Dangerous Place

The Workers’ Compensation system was developed to cover a range of work-related injuries and illnesses. Below is a list of representative accidents and health hazards the program encompasses. If you don’t know what to do if you’ve been injured on the job, it’s important to talk with a work-related injury attorney.

Injuries and Illnesses Covered

Back and Neck

Any injuries that occur from lifting or moving heavy objects, or other activities during the course of performing work activities. Back and neck injuries also may be caused by cumulative trauma.

Cumulative Trauma

These Injuries are caused by repetitive physical trauma such as carpal tunnel syndrome or other injuries from prolonged standing, lifting, or other work activities.

Communicable Diseases

Diseases such as COVID-19, AIDS, hepatitis, TB, or valley fever are work-related illnesses if it can be proven that the infectious source was work-related.

Occupational Exposure

Injuries such as hearing loss, allergic reactions, asthma, lung disease, and cancer have been caused or aggravated by workplace conditions, including exposure to toxins such as gasses, fluids, chemicals, and molds.

Heart Attack and Stroke

Any heart diseases, hypertension, or conditions that lead to strokes and other medical problems caused or aggravated by the job. For example, these sometimes occur with weight gain subsequent to a physical injury. (Read about Women's Hearth Health.)

Assault

Injuries that occurred from being struck, shot, or physically attacked by co-workers or customers, as well as any time you're the victim of a violent crime at work.

Auto Accident

Injuries that occur while driving between work sites, en route to training/work-related meetings, or performing work-related errands. However, injuries caused by accidents during regular commuting are generally not covered, although there are multiple exceptions.

Legs

Any conditions caused or aggravated by prolonged standing at work, such as phlebitis, knee or hip problems, or varicose veins. (Read about leg and knee injuries.)

Slip, Trip and Fall

These injuries are caused by falling on work premises, including sidewalks, floors, stairways, or parking lots.

Death

When work conditions cause or contribute to the cause of death by accidental injury, exposure, or illness, including heart attack or stroke, a worker's dependents may qualify for compensation. In some cases, a person might pass away outside of their workplace, but if it is proven later on that their death is related to their work, it can still be covered under Workers' Compensation Law. (Read about death benefits.)

How Are Psychiatric Injuries Covered?

Many psychiatric injuries are covered by Workers’ Compensation. These injuries can include psychiatric illness from an assault, post-traumatic stress disorder, sexual or other unlawful discrimination, brain damage, overwork/stress of the job, stress from co-employees, stress from physical injuries, or other “actual events” of employment.

What Psychiatric Injuries Aren't Covered?

Certain psychiatric injuries do not qualify for Workers’ Compensation under the California Labor Code. The work injury must be the predominant cause of the injury in most cases. 

In addition, psychiatric injuries substantially caused by good faith personnel actions are not covered. It is also important to note that most psychiatric injuries do not qualify for Workers’ Compensation unless there have been six months of total employment. 

Finally, psychiatric injuries arising as a “compensable consequence” of a physical injury are covered by Workers’ Compensation (temporary disability and medical care), but in most cases, the psychiatric permanent disability does not increase one’s overall percentage of disability.

Given the complexity of the law regarding psychiatric injuries, we recommend consulting with an experienced, knowledgeable Workers’ Compensation attorney, such as those of us at GEK, before filing a psychiatric injury claim. Without a knowledgeable Workers’ Compensation attorney, you may experience missed opportunities for compensation, inadequate representation, and potential loss of legal rights.

Am I Suing My Employer?

Workers' Compensation is a no-fault system; benefits are paid for injuries on the job regardless of fault. There is no lawsuit or civil action against your employer. 

Any dispute concerning what benefits are owed is decided by an administrative law judge. It is illegal for an employer to discriminate against workers for claiming an injury and/or hiring an attorney to assist them.

Why You Can Not Do It Alone

Injured workers are entitled to have an attorney assist them with their claims, guiding them through the system and advocating on their behalf. 

Given the complexity of the present law, it is advisable to have a skilled Workers' Compensation attorney on your side to ensure that proper benefits are received. Which doctor(s) you see and the end result of your case, including your benefits earned and the medical care you receive down the line, all depend on how well you understand the current laws regarding Workers’ Compensation. Different laws can result in outcomes for your treatment and compensation. So, it is important to know what the laws are to make sure you get the right care and support, that is where a trained attorney comes in. 

Attorney's fees are written in the law and usually are approximately 15 percent of the Permanent Disability benefits received. No up-front sums of money are allowed, and if no benefits are recovered, there is no fee.

Steps to Take if You Are Injured on the Job

There are no crystal balls that can help us foresee a workplace injury, but you can arm yourself with knowledge about what to do if you are hurt at work. Keep in mind that the California Labor Code allows employees to pre-designate a physician prior to an industrial injury. By doing so, the employee has the right to be treated by that doctor from the date of injury until treatment is concluded. The doctor must be the employee's regularly treating physician who maintains the person's medical records and who is willing to treat him or her in the event of an injury at work.

Reporting a Workplace Injury

• Even if you think your injury is "no big deal," report it to your supervisor immediately, and ask for a Workers' Compensation Claim Form.
• Complete the "Employee" section of the claim form and give it back to your supervisor immediately. Specify every part of your body you feel was affected by the workplace injury.
• Documentation is vital, so make sure you keep a copy of the completed form. Your employer must complete the "Employer" section of the form and return it to you within 24 hours.

Medical Care for On-the-Job Injuries

• Tell your supervisor if you need to see a doctor for your work-related injury. Treatment must be provided within 24 hours of filing the claim.
• Keep in mind that not all workplace injuries are orthopedic in nature. Hypertension, high blood pressure, diabetes, respiratory illnesses, skin cancer, toxic exposure and stress injuries can be caused by work.
• Some conditions may be merely aggravated by employment. This still qualifies as an industrial injury, and you have the right to file the claim for the aggravation of a pre-existing injury.
• When it comes to an on-the-job injury, details matter. Provide the treating doctor with a full account of how your illness or injury happened and include all the body parts that were affected.

When You’re Hurt at Work, Cover all the Bases

• Tell your supervisor if you need to see a doctor for your work-related injury. Treatment must be provided within 24 hours of filing the claim.
• Keep in mind that not all workplace injuries are orthopedic in nature. Hypertension, high blood pressure, diabetes, respiratory illnesses, skin cancer, toxic exposure, and stress injuries can be caused by work.
• Some conditions may be merely aggravated by employment. This still qualifies as an industrial injury, and you have the right to file the claim for the aggravation of a pre-existing injury.
• When it comes to an on-the-job injury, details matter. Provide the treating doctor with a full account of how your illness or injury happened and include all the body parts that were affected.

When You Are Hurt at Work, Cover All the Bases

• Document your work-related injuries.
• Attend all of your medical appointments and make sure to keep copies of all documentation regarding your on-the-job injury, such as notes from your doctor excusing you from work.
• Keep copies of all the letters, reports, etc. you have received from your employer or insurance carrier related to your work-related illness or injury
• Document/keep records of the following:
  1. Days off work.
  2. Dates of medical treatment.
  3. Round-trip mileage for medical treatment.
  4. Receipts for all out-of-pocket medical and prescription costs.
• Because you may have a third-party claim—a civil lawsuit against someone other than your employer—in addition to your Workers' Compensation claim, it is important to write down all the facts about your workplace injury. Such detailed information could help an attorney assess your potential civil case.

Stick to the Truth When You're Hurt at Work

Though it may seem like an easy way to get some cash, making a false or fraudulent Workers’ Compensation claim can have major consequences and is a serious offense. 

Making a false claim is considered a felony, which could result in up to five years in prison, a fine of up to 50,000 dollars, or double the value of the fraud. In some extreme cases, you could face both imprisonment and a fine. 

With all this said, if you do have a real workplace injury, it is important to keep all your facts straight and stick to the truth. For instance, when talking to your treating physician it is crucial to keep open and honest communication. You must detail your work duties, any injury-related restrictions, as well as hobbies, sports, or any other leisure activities you participate in. Your doctor will let you know if participating in any of the above activities will hurt your current condition. 

It is also important to note that what you post online will also become a part of your case. Your employer will be looking at platforms like Facebook, Instagram, Snapchat and more in order to verify the validity of your claim. 

Insurance companies also have the right to hire investigators to record your activities in public places, so your behavior should match the injury you are filing a claim for.

Seeking guidance from an experienced Workers' Compensation attorney to assess the specifics of your on-the-job injury is advisable.

If You Have Been Injured at Work…

• You need an experienced Workers' Compensation attorney on your side to develop effective methods of working within the system to achieve the best results for you. Timelines must be met, and deadlines adhered to; it's not wise to do this on your own.
• If you have filed a Workers' Compensation claim and received a letter from the State of California stating that you must pick a doctor from a panel list of three Qualified Medical Examiners (QME), you have an alternative option before complying with this request. Instead, immediately contact an experienced Workers' Compensation attorney who can help you find a different choice instead of blindly picking a random doctor off of a state-issued list.
• 1. Selecting the best Qualified Medical Examiner to suit your needs is vital to receiving the finest medical treatment to help you get back to work after an on-the-job injury or illness. The doctor chosen from a QME list could have a significant impact on your case, your future, and your family's future.
  2. Realize that you're not alone. A reputable Workers' Compensation attorney will fight for justice on your behalf.