The Law Offices of Dennis R. Fusi, PLC assists clients in Long Beach, Los Angeles, and throughout Southern California in workers’ compensation claims arising from on-the-job injuries and work-related disabilities and illnesses. We also practice immigration law, making us well qualified to advise and represent Mexican, Latin, and Korean immigrants who have been hurt while working in California. Please see our workers’ compensation FAQs page for more information about the claims process.
Understanding Workers’ Compensation Benefits
Employers are required by California law to pay for workers' compensation benefits when employees get hurt or sick because of work. Workers’ compensation is a no-fault system, which means that you do not need to prove that your injury was caused by another person in order to receive benefits. This also means that you may be compensated even if you were at fault in the incident that led to your injuries. Six basic benefits are provided by an employer's workers' compensation insurance:
- Medical care - Healthcare costs must be paid by the employer to help an employee recover from an injury or illness caused by work.
- Temporary disability benefits - These payments cover lost wages resulting from an injury that prevents an employee from doing his or her usual job while recovering.
- Permanent disability benefits - An employee is entitled to these benefits if he or she does not completely recover.
- Supplemental job displacement benefits - If your injury occurred in 2004 or later, these vouchers help pay for retraining or skill enhancement if an employee does not completely recover and does not return to work for his or her employer.
- Vocational rehabilitation - If your injury occurred before 2004, vocational rehabilitation benefits cover job placement counseling and possibly retraining if an employee is unable to return to his or her previous job and the employer does not offer other work.
- Death benefits - These are payments to the spouse, children, or other dependents of an employee who dies as the result of work injury or illness.
Types of Work-related Injuries
A work-related injury or illness may be the result of a single incident, such as a fall or equipment malfunction, or repeated exposures at work, such as constant loud noise and repetitive motions. For example, a delivery driver may be hurt in a car accident, while an office worker may develop eyestrain and carpal tunnel syndrome resulting from computer use and typing. So long as your injury or medical condition arose out of and in the course of your employment, it qualifies as a work-related injury.
Reporting an Injury
If you have sustained an on-the-job injury, been involved in a workplace accident, or have discovered that an illness or ailment stems from a work-related task or workplace environment, you must report your injury to your employer or supervisor as soon as possible. Reporting promptly helps avoid problems and delays in receiving benefits. Furthermore, proper injury reporting is often the first step to building a successful benefits claim. If you fail to report your injury or ailment within 30 days of the incident or discovery, you may jeopardize your ability to receive maximum workers' compensation benefits.
Filing a Claim
After being informed of your injury, your employer must give or mail you a Workers' Compensation Claim Form within one working day after you report your injury or illness, or after your employer learns about it. It is important to read all of the information that comes with the claim form, and then fill out and sign the "employee" portion of the form, being sure to fully describe your injury and include every part of your body affected by the injury. When you give the completed form to your employer, you have officially "filed" your claim.
Even at the onset of preparing a workers' compensation claim, the process can be slow and confusing if you do not know exactly what documentation and reporting is necessary to support your claim. Furthermore, if information is missing or inaccurate, it is more likely that your claim will be delayed, denied, or questioned. At the Law Offices of Dennis R. Fusi, PLC, our attorneys possess an in-depth knowledge of the claim process, and we will work tirelessly to protect your rights, plan a strategy for your case, gather information to support your claim, keep track of deadlines, and effectively represent you in workers’ compensation hearings.
Receiving Medical Care
In cases of medical emergencies, your employer must ensure that you have access to emergency treatment right away. For non-emergency care, the claims administrator is required to authorize treatment within one working day after you file your claim form. While investigating your claim, your employer must authorize necessary treatment up to $10,000. If your employer’s claims administrator does not authorize such treatment, speak to your supervisor, or other management, or the claims administrator. If immediate treatment is still not authorized, use your own health insurance to get medical care, or go to a doctor, clinic, or hospital that will treat you without immediate payment. The healthcare provider will seek reimbursement from your employer’s claims administer.
Seek Experienced Representation
The goal of the workers’ compensation system is to avoid lawsuits and to ensure that employees receive prompt and effective treatment for on-the-job injuries; however, sometimes disputes arise over issues such as the actual cause of the injury or the amount of benefits available. We counsel clients through every stage of the claims process, always working to ensure that injured workers and their families receive the full amount of benefits to which they are entitled under the law. If you have suffered a work-related injury, please contact the Law Offices of Dennis R. Fusi, PLC and set up a free initial consultation. Se habla español.