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Worker’s Compensation Frequently Asked Questions (FAQ)
If you’re reading this, you’ve likely been injured while on the job and have a lot of questions about what to do next. We know that it can be a confusing process, but it doesn’t have to be. Our team is here to help you every step of the way, starting with these frequently asked questions.
If you have another question that you don’t see discussed here, contact a representative from our team. We’re here for you.
If you’ve recently been injured in the workplace, the most important thing you can do is document everything that you can recall from the incident while it is still fresh in your memory and share all of these details with your employer. Not only will these help you throughout the legal and/or claims process, but failure to report in a timely manner could prevent you from receiving the benefits you’re entitled to.
While every workers’ compensation claim is different, there are common steps that are typically required by employers. Immediately after you report your injury, you will likely be sent to a doctor to assess your injury and ability to continue fulfilling your work duties. While this doctor is specified by your employer based on a network of doctors approved by insurance companies, keep in mind that it is your right to request a new doctor if you don’t feel comfortable with the one you were referred to.
It is a good idea to contact an attorney as early as possible so that your claim is handled correctly from the beginning. We offer free consultations to answer any questions you may have.
Based on the doctor’s recommendation, you may be required to take a leave of absence from work if it is determined you are unable to fulfill your normal work duties. Alternatively, you may be sent back to work with restrictions as recommended by the doctor. If your employer is not able to find a modified role that meets these restrictions, you have the option of not returning to work. This is considered “temporary disability,” and you are entitled to two-thirds of your normal wages should you take this type of leave. There is a cap on temporary disability benefits that amounts to $1,299.43 per week. You can remain on temporary disability until the doctor determines you can fulfill your regular job duties, until your employer can modify your role to a restricted one, until a doctor determines your injury has reached maximum medical improvement. During this time, you will be under a doctor’s care with the primary goal of getting you back to your pre-injury level of health.
Workers’ compensation programs are in place to prevent lawsuits between employees and employers and is a no-fault system. However, it is your right to file a claim if you were injured at work and the accident was not due to misconduct on your part. If it is determined that you were not engaging in horse play resulting in the accident, you may be able to access workers’ compensation benefits. Keep in mind, that it is not uncommon for insurance companies to deny benefits or pay out the least possible amount. If that happens, you have the option to dispute this decision and will likely benefit from legal guidance.
Under the California Labor Code section 4850, also referred to as “4850 Time” eligible peace officers and certain government employees may receive normal salary amounts in lieu of the standard 66 percent typically paid out for temporary disability benefits by the state. Eligible recipients will receive benefits for a maximum period of one year and, during this time. To put it simply, if you are deemed eligible, you should be able to collect the full salary that you were earning prior to your accident, while accruing service time for your pension.
If you are involved in another accident that takes place within this window, and are deemed eligible again, the eligibility period starts over and a new year-long period will start. After your benefits are paid out for the full year, you may be eligible for additional temporary disability benefits paid at the normal rate determined by the state of California. This is typically 66 percent of the salary you were earning prior to becoming injured.
Industrial Disability Leave (IDL) Benefits are available to employees of the State who are members of the California Public Retirement System (CALPERS) or the State Teachers Retirement System (STRS) and are determined to be temporarily disabled and unable to return to fulfill their job duties.
If it is determined that you are eligible for these benefits, you may be entitled to receive your full salary for the first 22 days after your accident. Following that time, you may be eligible to receive two-thirds of your normal net salary for an 11-month period following the first 22-day window. IDL Benefits are available for a maximum period of 52 weeks within a two-year period following an accident that is caused due to no fault of your own while performing job duties.
Enhanced Industrial Disability Leave (EIDL) Benefits are in place to protect the wages of injured public safety employees who are disabled for more than 22 consecutive days. If you are eligible, you may be paid the entire net salary you were earning prior to becoming injured. These benefits are available to protect eligible employees’ wages for a maximum of 52 weeks, or 2,080 work hours, within a two-year window that begins after an accident takes place. To be eligible for these benefits, your injury must have occurred during normal job duties and not as a result of injuries related to mental health such as stress. In those circumstances, you may qualify for Enhanced Industrial Disability Leave (EIDL) Benefits. The Workers’ Compensation Appeals Board does not have jurisdiction over IDL or EIDL benefits. Therefore, it is important to engage your union should an issue arise over these benefits.
Workers’ compensation insurance is paid into by your employer, as required by law. The benefits are in place to prevent lawsuits between employees and employers, and it is your right to file a claim should you become injured from an accident that occurred in the workplace. It is illegal for your employer to discriminate against you if you file a claim and the main thing to keep in mind is that, should you file a claim and collect workers’ compensation insurance, you will not have to sue your employer to do so. These benefits are in place specifically to cover medical care and other costs associated with on-the-job injuries if employees are eligible for benefits.
It is in your best interest to work with a team that has expertise in the complexities of workers’ compensation and employment law for many reasons. While you can absolutely represent yourself, in most cases, you will collect more money when represented by an attorney who is well-versed in employment law and workers’ compensation.
Also, keep in mind that the insurance company that handles your claim may seem like they are on your side but, at the end of the day, it is a business like any other and has a goal of making a profit for themselves. It is not the insurance company’s top priority to ensure that you receive the maximum amount of benefits that you’re entitled to, but it is ours.
We are not only here to break down the many barriers of communication that can come about throughout the claims and legal process and cause unnecessary stress, but your best interest and a favorable outcome is our top priority. We want to be sure you receive the maximum amount of compensation that you are entitled to, and we can assist with denial appeals and navigating settlements. We will work as your trusted resource throughout the entire process.
Initial consultations to discuss your accident with Novey Law Group are completely free and we operate on a contingency basis. This means that you are not charged a fee unless you receive an award. If no award is obtained, no fee will be charged. If you receive workers’ compensation benefits or a lump sum settlement amount, these can be used to fund any attorney’s fees that you owe. A set percentage will be established in advance.