What Are The Proper Steps To Take If You Have A Valid Workers’ Compensation Claim In California?
The first step should always be to seek immediate medical treatment. It is also very important to clearly report to a doctor at a medical facility that the injury is work-related and to describe how the injury occurred so that it can be properly reflected in the medical records. The second step would be to report the work injury to your employer as soon as possible. At that time, the employer does have an obligation to provide you with a workers’ compensation claim form to fill out. The next step would be to seek the services of an experienced workers’ compensation attorney to ensure that your claim is processed correctly and all necessary documents are properly filed with the courthouse. Once you obtain the services of an attorney, then that attorney can handle all further steps necessary to ensure that you collect the maximum benefits possible.
What Evidence Is Going To Be Critical In Proving My Workers’ Compensation Claim?
Any evidence that proves that a worker is an employee and that their injury arose out of employment during the scope and course of employment is very critical in proving your claim.
For example, if employment is at issue and the insurance carrier is claiming that the worker is not an employee, then paystubs, wage statements, and personnel files can be used to prove that the worker is in fact an employee. Any health records or medical reports that establish medical causation between an employee’s injury and their work duties would be critical to proving that the injury is work-related. Time sheets or surveillance videos that would prove that the worker was injured during normal work hours may also be critical to the case. Any surveillance video of the incident itself would also be valuable evidence to prove the mechanism of the injury as it occurred.
How Long Does Someone Have In California To Actually File A Workers’ Compensation Claim?
An injured worker has a basic obligation to report an injury to their employer within 30 days and then they have one year to actually file their claim. That one-year statute of limitations is applied from the date of injury or from the date of the last furnishing of monetary benefits or medical treatment that is provided by the employer.
Will I Be Able To Choose My Own Doctor For My Work-Related Injury? Should I Choose My Own Doctor, If My Company Is Making Referrals?
Whether you can choose your own doctor depends on whether an employee pre-designated their own private physician beforehand and whether the workers’ compensation insurance carrier maintains a medical provider network list. If there is a valid list and the employee has not been designated a doctor, then the employee must select the doctor from that list. If the employee has pre-designated a doctor or there is no valid list, then the employee has the right to choose their own workers’ compensation doctor for their work-related injuries. It would be prudent for an injured worker to conduct some research and choose a doctor that they are most comfortable with, who can provide them the best treatment possible.
What Information Should I Share With My Doctor After An Injury?
It is very important that an injured worker provides information and details as to how their injury occurred and when and where the injury occurred. That information should be shared with their doctor.
When It Comes To Defenses, What Are Some Of The Reasons A Workers’ Compensation Claim Would Be Denied Or Disputed?
One of the most common grounds for an insurance carrier to deny a claim would be if employment is at issue. The insurance carrier might contend that the injured worker is an independent contractor, as opposed to an employee. Another common basis for denial would be if there is no substantial medical evidence to support that an injury was caused by work. The insurance carrier would be claiming that the injury did not arise out of employment. Another basis for denial could be if the injury did not occur within the course of employment or if the workers’ compensation case was barred by the statute of limitations.
If the injury was caused by horseplay or intoxication, or if the injured worker was the initial aggressor in an altercation that caused the injury, those are grounds for denial. One other defense that an insurance carrier can raise to ultimately deny the case is called a post-termination defense. If the claim was filed after an employee was terminated from employment, then there is a presumption that the claim was merely filed in retaliation. The case would likely be denied until the employee can overcome that presumption with evidence.
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) 925-9255 today.
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