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

On-the-job injuries in Southern California continue to occur at an alarming rate. Schools, hospitals, restaurants and grocery stores can be danger zones for workers. 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. Those who are hurt at work may be unable to return to the 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.

California’s Workers’ Compensation laws provide injured workers with benefits designed to help them receive the medical treatment necessary to recover from the work-related injury or illness and partially replace lost wages. Injuries that qualify as “industrial” are categorized as specific, those that result from a specific event, or cumulative, trauma that occurs over time.

Metal worker hurt at work

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

Injuries 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 (see below).

Cumulative Trauma

Injuries 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, if it can be proven that the infectious source was work-related.

Occupational Exposure

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

Heart Attack and Stroke

Heart disease, 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.

Assault

Injuries from being struck, shot or physically attacked by co-workers or customers, or as the victim of a violent crime at work.

Auto Accident

Injuries occurring while driving between work sites, in route to training or work-related meetings, or performing work-related errands. Injuries caused by accidents during regular commuting generally are not covered, although there are multiple exceptions.

Legs

Conditions caused or aggravated by prolonged standing at work, such as phlebitis, knee or hip problems or varicose veins.

Slip, Trip and Fall

Injuries caused by falling on work premises, including sidewalks, floors, stairways or in 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, the death occurs away from the workplace but may later be shown to be an industrial-related death.

Psychiatric Injuries

Many psychiatric injuries are covered by Workers’ Compensation. Such 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.

However, certain psychiatric injuries don’t qualify for Workers’ Compensation under the California Labor Code. The work injury must be the predominant cause of the injury in most cases. Psychiatric injuries substantially caused by good faith personnel actions are not covered. Also, most psychiatric injuries do not qualify for Workers’ Compensation unless there has 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.

Nurses hurt at work

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 heard by an administrative law judge.

Injured workers are entitled to have an attorney assist them with their claim, guiding them through the system and advocating on their behalf. It is illegal for an employer to discriminate against workers for claiming an injury and/or hiring an attorney to assist them.

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. The doctor(s) from whom you can receive medical care and the final outcome of your case in regards to your right to future medical care and monetary compensation depend on an understanding of the complexities of the present law.

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

Electrical worker hurt at work

Steps to Take if You Are Injured on the Job

There are no crystal balls that can help us foresee a workplace injury, but we can arm ourselves with knowledge about what to do if you're 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.

In addition, keep in mind the following tips on protecting yourself if you suffer a job-related injury or illness; adhering to them could positively impact the benefits you receive.

Reporting a Workplace Injury

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

Hurt on the Job?
  • 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

Document your work-related injuries
  • 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

Hurt at Work Lawyer
  • Making a false or fraudulent Worker's Compensation claim is serious business. Serious enough to be considered a felony subject to up to five years in prison or a fine of up to $50,000 or double the value of the fraud, or both imprisonment and fine.
  • It is imperative to have an open and honest dialog with your treating physician. This should include not only explaining in detail your work duties and any restrictions the injury may cause, but also what you do in your free time—hobbies, sports, activities, etc. Your doctor can then guide you about whether participating in these activities may or may not be advisable given your current condition.
  • Social media can be your enemy if you are not being honest about your claim to be injured on the job. Your profiles on such social media sites as Facebook, Instagram, Snapchat and others will be reviewed by your employer to discover if you are telling the truth about your injury.
  • Keep in mind that it is legal for the insurance company to hire a professional investigator to video record an injured worker anywhere in public, such as at a grocery store, outside church, driving a car, even merely walking in the front yard to pick up the mail.
  • Consult with an experienced Workers' Compensation attorney and review the facts and nature of your on-the-job injury together.

If You Have Been Injured at Work…

Have you 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 receive 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.

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