The point of going to work is to earn money to support your family - not to contract illnesses or experience injuries that impact both your personal and your professional life. An injury or illness on the job can take you out of work and make your private life difficult to deal with, given the injury and related medical needs that might emerge from it. Being injured on the job can not only take you out of work and cost you earnings, but can also result in a lot of medical bills and related costs.
When you’ve been hurt on the job, a knowledgeable Orange workers’ compensation lawyer can answer any queries you have about your claim.
Often Experienced Work-Linked Injuries
Injuries on the job are not expected, but they happen more than you might think. Work-related injuries are a huge problem in the U.S., and the U.S.Bureau of Labor Statistics reports that there were 2.8 million nonfatal work-related injuries and illnesses in 2019.
CA Workers’ Compensation Explained
The workers’ compensation program in California is a no-fault system that ensures your ability to collect benefits when you are injured or become ill in the workplace. What that means is that you are guaranteed benefits regardless of whether your or your employer caused the accident and injury, but as a trade-off, you cannot then sue your employer for the damages associated with the injury.
The California Division of Workers’ Compensation enforces the rules, policies, and procedures through which your claim and any related appeals are processed. If your injury was due to a third party that was unrelated to your employer, you may be able to pursue damages from the third party. Workers’ compensation is meant to provide you coverage to get past the medical bills and lost earnings of your injury, as discussed below.
Which Benefits May I Collect in Orange?
There are two primary benefits that you can collect through your workers’ compensation: medical expenses and lost income. When you are injured or become ill on the job, you are not supposed to have to pay for any of your related medical bills, including:
- ER care immediately after the injury
- Follow-up medical assessments
- Doctor and specialist appointments
- Related medication and medical equipment
- Any necessary rehabilitation or treatment
- Hospital and surgery bills
- Any required at-home healthcare
Outside of benefits linked to necessary medical care and treatment for your injury or illness, you are also entitled to receive compensation for the lost income that your injury and the period of rehabilitation following it might entail.
Your injury may prevent you from returning to work at all for a short or long period of time, or you may also not be able to return to a job that pays a similar amount to what you made before. Replacement of your lost wages can include disability payments for:
- Permanent partial disability
- Permanent total disability
- Temporary partial disability
- Temporary total disability
Covering your lost income is an essential piece to recovering from your injury and getting on with your life. The process of filing seems relatively straightforward, although it is important to remember that the insurance company must see specific information and evidence to approve your application, and an experienced workers’ compensation attorney knows what factors to include in support of your application.
How to File Your Workers’ Compensation Claim
The process of filing your workers’ compensation claim is a two-step process, and it is not something that happens automatically after an injury or illness has taken you out of work. You must first fill out the application on your end, including evidence in support of your need to collect medical bills and replacement wages.
Then, your employer must fill out their own portion of the claim form, then forward it to their workers’ compensation insurance company. Having a date-verified copy of when you submitted your claim to your employer helps ensure that it is timely processed, which can be done by sending your application through certified mail.
After both you and your employer complete your portions, the claim is submitted to the insurance company, which then scrutinizes your application to determine if they can reject or reduce it for any reason. While filing and quickly collecting on your full benefits is ideal, this does not always happen, and you might encounter issues with your claim.
Common Issues Your Claim Might Face
Filling out your application and timely submitting it would ideally result in you receiving your benefits soon, but that is not always the case. The insurance company works for profit, not for you, and they will reject or reduce whatever claims they can in order to maximize their profits. Ensuring that your application is complete, accurate, and includes sufficient evidence is essential to be approved the first time around instead of being denied and having to pursue an appeal.
Common issues that you might face with your workers’ compensation claim include:
- Inaccurate or incomplete paperwork application
- Arguing that your condition was not work-related
- Arguing that your condition was pre-existing
- Challenging the severity of your injury and requiring you to see their doctor
There are a number of reasons through which the workers’ compensation insurance company can deny your claim and require that you challenge the denial. An initial denial of your claim can lead to a time-consuming appeals process, one that will delay the receipt of the benefits you need to get past your illness or injury and move on with your life.
Connect with an Orange Workers’ Compensation Lawyer Now
An experienced workers’ compensation attorney has processed many claims and appeals in your area and knows what the workers’ compensation insurance company is looking for when analyzing your application and what information will support its successful processing. Knowing what information to include, what evidence to collect in support of your case, and how to make sure it is presented in the best possible way is where the value of a workers’ compensation attorney is realized. To discuss options on your case, schedule a consultation today.
