Most of our lives are spent at work. For most, the 9 to 5 workday is the norm. Throughout your work life, accidents may be unavoidable while executing your duties, specifically, if most of your work revolves around physical labor. Resolving these injuries with your income can take a toll. This situation is what a workers’ compensation insurance policy seeks to remedy.
Workers’ compensation is an insurance policy taken against any employment-related illnesses and injuries such as the knee, ankle, and foot injuries. The insurance policy is provided to the employee to ensure that medical costs, as well as other incidental expenses that result from an accident at work, are taken care of properly. The government, through the laws discussed herein, provides a framework to protect the interests of the employees through the Workers’ Compensation Program. However, workers may experience some challenges in receiving their dues from the policy as much as the program provides under law. Nevertheless, with the experience of The Workers Compensation Attorney Group, you stand a better chance in receiving what is owed to you in the event of an accident at work than when you pursue the honoring of the policy terms. Our team’s experience has served many workers in Orange County, CA and you too can tap into this experience to address your case.
The Guiding Principles of Workers’ Compensation
A Workers’ Compensation Program is structured to safeguard the employee in the event of an accident at work. Fault in the misfortune is not an issue often explored at first instance. The primary concern of the insurance company is if the injury inflicted happened during the employee’s ordinary course of executing their responsibilities. If it is determined that the damage was work-related, the employee’s claim for the compensation benefits will be honored. It is expected that the worker, as well as their dependents, may experience hardships such as loss of income, and meeting medical expenses following the accident, as such, the benefits are paid to address these hardships. The insurance policy further ensures a win-win scenario for both the employee and their employer. Employees reap the benefits of the policy while the employers are precluded from legal action for the injuries.
Legally, every employer needs to have a Workers' Compensation policy for all its employees. There are expectations that the employee will exercise caution in the day to day responsibilities of work. Injuries that the insurance provider will pay benefits for are those sustained as accidents and not due to carelessness on the part of the worker. Mandatory alcohol and drug tests may be administered from time to time as a precautionary measure in place within the company to avoid incidences owing to the employee’s carelessness. Further, the entity may have in place other policies driven to ensure the safety of the workers is not compromised. If as an employee you were to suffer an injury as a result of the disregard of these policies, the compensation benefits will not be honored. That means that operating in the company while under the influence of alcohol or drugs, or the blatant disregard of the policies in place is considered as carelessness on your part. Therefore, if you sustain an injury by not exercising caution, your injuries may be regarded as self-inflicted.
Some injuries may result because of the employer’s negligence. However, their fault in the accident and the harm that occurred is not the pursuit when filing a workers’ compensation claim. The law does not prevent you from suing your employer for the injuries sustained. Nevertheless, in so doing, you forfeit your right to the benefits provided for in the compensation policy. Most people go for the lawsuit option because the sums paid in damages are higher unlike those paid out in a workers’ compensation package. The downside to a lawsuit is that in case it is unsuccessful, you do not receive any sums to compensate you for your injuries.
Types of Benefits You or Your Dependents can Claim
According to the California Code, Labor Code - LAB § 5400, any work-related injury should be communicated to the employer in written form within thirty days of the accident occurring. The employer should then give a workers’ compensation claim form to the employee within a day of receiving the written injury notice. The employee is then expected to file the claim within the year according to section 5405 of the Labor Code.
There are five benefit packages accessible to you as an employee or your dependents in the event of an injury. They are provided for you under California Code, Labor Code - LAB § 4600 through to § 4700. The benefits include;
This package offers sums that are directed for settling your medical bills, treatment services, medicines, as well as any costs incidental to the treatment of the injury. Medical care is designed to ensure your speedy recovery without the worry of medical bills and the cost of treatment.
The recovery period may see you spend some time off work and it may come with the risk of losing your wages. Temporary disability ensures that you do not lose your income because of the period spent in getting better.
Permanent Disability Benefits
Injuries sustained may in some situations lead to a permanent disability. Having a permanent disability means that you do not recover from your injuries and lose the ability to work. In such cases, sums are paid to you as compensation for this disability.
Supplemental Job Displacement Benefits
The sums paid are meant to cushion the loss of income due to the injury sustained. However, this is only payable if your employer does not offer you another position in the company, you choose not to go work for the company, or you are eligible for the permanent disability benefits.
Workers Injured in 2004 or the Years After are eligible for the supplemental job displacement sums. The law provides that if the injuries were sustained in 2013 or after and you received the amounts paid out as supplemental job displacement benefits. In such a case, you are eligible for an extra one-time payment as offered under the Return-to-Work Supplement Package.
These are amounts paid to your spouse, children, and/or your other dependents in case of your demise from the injury sustained at work.
Your financial recovery from the injury is not limited to the Workers' Compensation policy. You can also file a suit against third-party contractors, equipment manufacturers, and property owners. All sums paid to you in these suits will not be subject to the workers’ compensation laws. It is considered that liability for the accident is not limited to the employer. However, for purposes of addressing workers’ compensation, the employer is the party of interest.
All amounts paid out as compensation are subjected to the provisions of the law. The benefits paid to you do decrease over time as you heal gradually and resume your responsibilities. It is worth noting that the workers’ compensation plan is available to both private and public sector players. Some of them include those in the construction business, the railroad sector, and volunteers, among others. The Workers' Compensation plan covers federal government employees at the national government level. They thus are not eligible for coverage at the state level.
Some steps need to be followed when you are injured at your workplace.
First, you should seek medical treatment. It is expected that you will receive treatment from a predesignated physician or an approved medical service provider. Then you will need to fill out a claim form.
Upon receiving the form, the claim administrator or employer must pay out the sums needed for treatment within a day of receiving the claim. You may receive $10,000 initially as the insurance company decides on the merits of your case. When approved, the sums due to you will be paid under the terms agreed upon subject to the prevailing legal provisions. If your claim is rejected, you can present your case before a judge. You will be required to apply for an Adjudication of Claim with the proper documentation attached. The matter is then slated for a mandatory settlement conference. If your case is not addressed to your satisfaction, then you can file a Reconsideration Petition.
An Assessment of an Ankle Injury Under Workers’ Compensation
Many people suffer from ankle injuries when they are at work. The injury becomes evident through a damaged ligament, a fractured bone, or a torn muscle or tendon. The injury may call for an immediate consultation with a prescribed doctor. Their assessment of the damage could result in you using ankle support or an elastic compression band. The band will help reduce the swelling and ease the pain on the ankle. In some extreme cases, surgery is an option your physician may recommend. All the above experiences hinder your ability to work. There is a further risk of you losing your income during the recovery period, a situation the worker's compensation package addresses.
When you injure your ankle and file for compensation, you are paid sums that cater for your medical expenses and the income sums you risk losing during the recovery period. You should, therefore, expect to receive at least two-thirds of the income you earned at the time of your accident. The cost of your medical treatment is added to the claim payment.
The nature of your injury guides the insurance as to what sums you should receive from the claim. You, therefore, will get benefits depending on your injury.
Temporary Total Disability
Benefits are paid when your injury causes some form of permanent disability. However, temporary total disability can be addressed through medical care.
Temporary Partial Disability
The sums paid out cater for a temporary loss of the ability to work. The injury only inhibits your work output for a short period. Therefore, the benefits compensate you for the loss of income during this short recovery period.
Permanent Total Disability
Benefits paid for in this situation cater for your expenses and the loss of your income. The assumption is that the injury has impaired your ability to work and thus you cannot go back to work in the same capacity or any other position offered by the company.
Permanent Partial Disability
Most people who apply for a claim in this package can no longer return to their previous position at work. The injury makes it difficult for them to perform the tasks they handled before the injury. Therefore, the benefits paid out help ensure that you have a smooth recovery period if you suffer an ankle injury.
Any compensation claims made needs to have accompanying proof. A physician’s assessment and medical treatment is sufficient. Ensure that the diagnosis is indicated and a detailed account of your treatment offered. If there was a witness to the accident that led to your ankle injury, be sure to have their account in writing attached as evidence when making a claim.
An Assessment of a Foot Injury under Workers’ Compensation
Foot injuries account for a significant portion of claims made under the workers' compensation package. Foot sprain, burns, cuts, and lacerations are some of the knee injuries featured in the claims. Broken feet, amputation of a toe, foot, or feet, fallen arches, and bunions are also considered in the claims. All these cases should have occurred within the workplace and while carrying out your responsibilities. Only then can you have a successful claim and receive the benefits warranted to you.
In most cases, knee injuries are as a result of a few hazards in the workplace such as, slippery floors that lead to falls. Fractures, twists, or sprained feet then result.
Long-standing hours as part of your work will result in corns, bunions, and fallen arches on your feet. All these types of issues are considered a foot injury.
Falling or rolling of heavy objects, whose results are a broken bone, puncture wound, or amputation.
Spill or a splash of chemicals solutions that result in burns especially if the worker did not have the needed safety equipment and gear.
The high electric voltage in equipment or wires that are exposed due to an electrical fault may cause danger of an electric shock or a fatal outcome especially if the working environment is wet.
Exposure to extreme cold working environments may cause some injury. Most foot injuries in such settings include frostbite, hypothermia, and in other cases, amputation of a foot or feet.
Working in an environment with sharp objects or operating machinery that exposes the worker to sharp elements in the piece of equipment. There is then a risk of a worker suffering lacerations, cuts or foot punctures.
Most foot injuries impair a worker’s ability to resume their duties. Severe foot injuries that result in disabilities introduce a new life for the worker; living without the pay packages, they were entitled to receiving. If you had a foot injury, you risk losing the additional employment perks you enjoyed such as medical coverage and access to a retirement package. While the workers' compensation may cater for a portion of your income as well as the cost of the medical treatment, injured employees generally lose and have to make a lifestyle adjustment to suit their present condition. This lifestyle adjustment is a common situation for many employees who have had foot injuries as most employers have insurance packages that terminate such employment perks if you do not work for six months to a year.
An Assessment of a Knee Injury Under Workers’ Compensation
Knee injuries cause pain and unbalanced walking that compromises the quality of work. Similar to ankle and foot injuries, knee injury claims are rewarded against the specific damage and all incidental costs of the injury. The workers' compensation package covers torn ligaments, knee repair surgeries, and torn meniscus among others. If you have suffered any of the above, you can access the benefits offered under the compensation plan.
Your claim for the workers' compensation must be backed up by evidence of the knee injury. It, therefore, calls on you to ask for a detailed medical assessment on your injury. This assessment must include the treatment you have received as well as the cost implication. If anyone witnessed your accident, it is best to include their statement in your submissions for the claim.
Knee injuries do vary depending on the circumstances that led to the accident. Some types of knee injuries are categorized under traumatic injuries such as;
The meniscus is cartilage found in the knee joint. Pressure may cause the cartilage to twist or dislodge, and this may cause lead to the tear of the meniscus.
Most fractures affect the patella, which is the bone around the knee. The bone protects the knee joints. A fall or a direct force on the bone will cause it to fracture. The pain may be managed through medication and the fracture corrected through surgery. However, your walking may be affected.
Injury of the Anterior Cruciate Ligament (ACL)
A direct impact on the knee will affect the ACL, which is a ligament in the knee. Such damage on the knee may be a result of a fall or any other accident that results from a direct force applied to the ligament.
A dislocation happens when the bones in your knee are displaced from the socket in the knee structure. The pain is excruciating, and the injury to the knee may need urgent medical attention. However, in most cases, the dislocation does not always lead to a change in your mobility.
The medical treatment for these injuries ranges from surgery, physical therapy, medication, and in some cases, injections. If these medical solutions are not administered on time, you risk suffering chronic pain, instability while walking, functional impairment, disability, or post-traumatic arthritis. Knee injuries may take longer to heal, and this affects your income generation during the recovery stages. The incidental costs to the injury also affect the quality of your life, and these are the issues the compensation package addresses.
Steps to Take When You are Injured to Access Your FELA Claims
The steps elaborated herein are meant to protect your rights when making a claim. Your actions that proceed the injury have a bearing on the success of the workers' compensation claim.
Employer’s Injury Report
After an injury, you should immediately inform your supervisor or employer about the damage. The report should include all details that give an account of when, how, and the extent of the injury sustained. If you are not in a position to do it yourself, you can always seek help.
Seek Medical Treatment
Get medical attention from a pre approved physician. Be sure to detail all the pain and difficulties you experience due to the injury. The information forms part of the doctor’s assessment that will be attached to your claim. Always remain truthful.
Pursuing a Claim
Have a separate report of the details of the injury as a personal copy as well as one that you will forward to your attorney. The report document issued to the various parties should all match in the details of the accident. That is, there should be no discrepancies in the reports issued to your supervisor, employer, doctor, insurance provider, and your attorney. The information should also include details of the time you have missed work.
Contact Your Union Representative
It is vital that your union is made aware of the injury. Their input in the process goes a long way in securing the funds payable to you.
Hiring a Orange County Workers Compensation Lawyer Near Me
Workers’ compensation matters require attention to detail, procedures and strict adherence to the legal provisions. It is only in addressing all of the issues mentioned above can you have a chance at a successful legal redress for your injury. It is often difficult pursuing workers' compensation claims as well as pursuing any suit against an employer. That is why you need legal experts. The Workers Compensation Attorney Group is ready to assess your case, offer assistance, and set up a winning strategy to ensure that you are adequately compensated for your injuries. Be sure to give us a call today at 562-485-9694, and we will be glad to set up a consultation for you.