Could My Medical History Be Used Against Me In A Workers’ Compensation Case?
According to the California Labor Code, an employer is only liable for the portion of a disability that was directly caused by their employment. For that reason, an insurance carrier can and will inquire into a claimant’s medical history to see if there were any prior injuries, conditions, or illnesses which may have caused or contributed to the injuries claimed as part of the workers’ compensation case. Depending on the nature and severity of any prior injuries, it could lower the overall value of the settlement.
How Could Recorded Statements Be Used Against Someone In The Workers’ Compensation Claim Process?
Any type of recording, assuming that it is properly obtained and authenticated, can be used to contradict statements that are made during the course of the claim. This, in turn, can be used to test credibility and character.
Why Might Insurance Companies Obtain Surveillance Of Injured Workers? Is This Legal?
Insurance companies have the legal right to conduct surveillance of an injured worker, as long as it does not invade their right to privacy. It is not uncommon for insurance companies to conduct surveillance on a completely random basis or on a specific file because they suspect fraudulent activity.
I Don’t Know If I’m Able To Go Back To Work While My Case Is Pending. Should I? Could It Be Used Against Me?
It is possible for an injured worker to return to work with or without work restrictions and still pursue their case without limitation. Whether or not employees should go back to work should be a medical decision which an injured worker should discuss with their doctor However, if an injured worker is released to return to work by their doctor, then failing to do so can be grounds for termination from employment for job abandonment.
Why And How Might Insurance Companies Attempt To Use Delay Tactics To Draw Out The Workers’ Compensation Claim Process?
Insurance companies sometimes use delay tactics when they are contesting the merits or the validity of the claim in order to provide them more time to investigate the case.
However, if the delay tactics are used for improper motives, such as refusing to pay benefits simply for cost savings, then those delay tactics can be brought to the court’s attention and disciplinary measures, such as sanctions, can be imposed.
How Are Workers’ Compensation Benefits Calculated In California?
The main benefits in a workers’ compensation case are temporary disability, permanent disability, potential life, pension benefits, supplemental vouchers, death benefits, and medical care.
Temporary disability benefits are monetary payments that are paid to an injured worker to compensate them for any wage loss that they may have incurred while they are treating for a work-related injury. These benefits are calculated and paid out at a weekly rate of two-thirds of an employee’s average weekly earnings and are subject to a minimum and maximum amount that is set by law.
Permanent disability benefits are monetary payments intended to compensate an injured worker for any residual impairment or disability that is caused by a work-related injury. They are paid out at the rate of two thirds of a person’s average weekly earnings and they are subject to a minimum and maximum amount set by law. The maximum and minimum amounts are much lower than they would be for temporary disability benefits. Also, permanent disability benefits are paid out over a set number of weeks, which increases as the percentage of the permanent disability that is assigned to the injury increases. If the percentage of permanent disability is equal to or exceeds 70 percent, then in addition to the permanent disability benefits, the applicant would also be entitled to receive a life pension, which are small weekly payments that increase in dollar value for each permanent disability percentage over 70 percent.
An injured worker can also possibly receive a supplemental job displacement voucher, which is a voucher for up to six thousand dollars that can be used for retraining and for vocational schooling, tuition, and supplies. An injured worker is entitled to the voucher If they have a permanent partial disability and their employer does not offer them regular or modified work.
Another benefit that an injured worker can be entitled to receive is medical care, paid for by the insurance carrier. The actual treatment that you can receive is subject to medical treatment guidelines, which state what type of treatment can be provided for a specific injury and the cost of those medical treatments are subject to certain limits.
The final type of benefit would be death benefits. In the unfortunate event that a work injury causes the death of an employee, the dependents of the deceased employee would be entitled to receive monetary death benefits to compensate them for the loss of support they were receiving from the employee at the time of death. The amount of death benefits would depend on the number of total and partial dependents and are also subject to a maximum amount set by law.
There are certain additional benefits, like reimbursement for mileage costs when traveling to doctors’ appointment.
What Are Some Of The Factors That You Discuss With Your Clients When It Comes To Considering Whether Or Not To Settle A Workers’ Compensation Case?
The main factor to consider when deciding whether or not to settle your case is whether the settlement offered is fair and reasonable and adequately compensates you for your work injuries. If not, then you always have the option to proceed to trial and present your case to a workers’ compensation judge.
There are two different ways to settle your case and you would need to decide which settlement option is best for you. One option is to accept small weekly payments for any permanent disability you may have and leave your future medical care open. The other is a lump sum settlement where you would receive the full amount for your permanent disability up front and receive another upfront sum of money to settle out the future medical care for your work injuries.
How Could A Workers’ Compensation Settlement Or Benefits Impact Other Benefits Someone Is Perhaps Already Receiving?
Generally speaking, the law disfavors collecting benefits from two different sources for the same injury. Receiving a workers’ compensation settlement or benefits can possibly impact certain other monetary benefits that an injured worker may be receiving for that same injury.
For example, if an employee was receiving Social Security disability benefits, then these types of benefits might be offset by the workers’ compensation settlement.
Oftentimes, these other plans require that an injured worker report any type of workers’ compensation settlement or benefits that they receive.
Is There An Advantage To Taking A Lump Sum Settlement Versus Weekly Benefits?
The advantage to settling by way of a lump sum option is that the employee oftentimes receives a larger sum of money upfront and can gain greater control over their future medical care. Rather than receiving smaller weekly payments for their permanent disability benefits, they receive the full amount upfront, which can be more financially advantageous to that worker. Rather than being forced to treat through the workers’ compensation system for their future medical care, they can instead receive a lump sum of money for it and still get the same medical treatment from their own private doctors.
Are There Any Downsides To A Lump Sum Settlement? What If My Injuries Resurface Or Get Worse Down The Line?
The biggest downside to a lump sum settlement is that you would no longer be able to request any further medical treatment from your employer or the workers’ compensation insurance carrier in the future if your injuries worsen over time. For that reason, an injured worker must ensure that the settlement is fair and reasonable and does adequately compensate them for settling out their future medical care.
Should I Hire An Attorney Immediately After An Injury At Work Or Should I Wait For A Denial First?
It is highly recommended that an injured worker hire an experienced, competent attorney immediately after an injury, rather than waiting until after the case gets denied.
We will know how to properly set up and process the claim from the beginning to avoid any unnecessary delays or denials. Furthermore, an attorney can immediately begin working on the case and develop the case with the proper medical reporting and the proper evidence to prove the claim in order to maximize the benefits.
What Are Some Of The Risks When Someone Tries To Handle A Workers’ Compensation Case Without An Attorney?
The biggest risk in handling these cases yourself is the lack of knowledge and experience with the workers’ compensation laws, regulations, and court procedures. As a result, an injured worker who represents themselves will be at a major disadvantage when litigating their case against the workers’ compensation insurance carrier and their experienced legal team. I have seen several injured workers try to represent themselves against experienced defense attorneys and they were not able to maximize and collect all the benefits that they would have been otherwise entitled to collect.
For more information on Workers’ Compensation, a free initial consultation is your next best step. Get the information and legal answers you are seeking by calling (818) 949-1918 today.
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