A Confidential Word to the Unrepresented Injured Worker

Psst, you – hey you, c’mere. (glancing around furtively) I got a secret to share with you: This system stinks. Get out while you still can……

Every injured worker will make more money working than being on worker’s compensation. 

Reforms in 2004 drastically slashed benefits available to injured workers.  The days of excessive treatment and ongoing benefits are gone.  Most people who are subjected to the reduced benefits and excessive regulations say they wish they never filed a claim form.  It is financially draining for a long period of time. Benefits are often withheld, claims adjusters are unresponsive, and 65% of all medical treatment requests are denied through a kangaroo court process called Utilization Review (“UR”).  It’s common to go through several claims adjusters on your case, and to them, you are just a file. I tell injured workers the best thing I can do is get you through the system quickly, obtaining all the benefits you are entitled to, and structuring your settlement to reduce the impact on Social Security benefits.

You do not need an attorney to proceed through the worker’s compensation system. Over 70% of worker’s compensation claims are not litigated.  The WC system is supposed to work automatically as a benefits delivery system.  Step one, step two, step three. If this, then that. At least that’s how it’s supposed to work.

Many times, workers get so frustrated with the red tape and delays in worker’s compensation and just go to their private doctor, not pursuing a claim of injury against the employer.  The claims adjusters love this, because then they can just close the file and not pay any benefits. How do I know? Because I was a WC insurance defense attorney for over ten years. I know the tricks used to get injured workers to waive valuable benefits, the language that will protect the insurance company while leaving you responsible.

If you have a work injury severe enough to have to retire and apply for Social Security benefits, you need a lawyer.  

Attorney’s fees are capped at 15% of the permanent disability awarded in Stipulations, and 15% of a total Compromise and Release. Most awards are extremely low.  Remember the insurance company is actuall y working for your employer, not you.  It is not unusual for an insurance company to delay for years and years on a minor case. Many people simply give up. Add in reforms, case law, an administrative law procedural process (the California Labor Code), and quickly people end up confused and frustrated trying to navigate the system.

You may be eligible to receive benefits even if you are a temporary or part-time worker; a contractual or intermittent employee, such as an Uber driver; and even if you were injured in an at-fault motor vehicle accident in a work vehicle.  If you have been involved in a motor vehicle accident while working, I strongly encourage you to consult an attorney, as this would have a third party claim issue and a possible civil recovery in addition to worker’s compensation benefits.

We can also help you investigate all other sources of income. Benefits will often cut off suddenly and without notice once a doctor has indicated you have stabilized, also called “permanent and stationary status.”

Sometimes, just getting someone on your side to guide you through the process is enough reason to hire an attorney. Our fees are paid at the end of the case, and are generally limited to 15% (fifteen percent) of the permanent disability awarded.  If you don’t get an award, we don’t get a fee; that means that we have to be very careful about the type of cases we accept for representation.

Other Facts to Know:

  • You don’t have to be a legal resident of the United States to receive most workers’ compensation benefits; even without a social security number.
  • An employee can file a request to have a denied worker’s compensation claim re-evaluated through the Panel QME process.  There are time deadlines for this process.
  • It’s illegal for your employer to punish or fire you for having a job injury or for requesting workers’ compensation benefits when you believe your injury was caused by your job.
  • Temporary Disability is only paid when you can’t work your regular job due to an injury, and modified work is not available with your employer. Disputed claims for temporary disability are common, often leaving injured workers with no income for weeks or months while the insurance carrier disputes it at the WCAB.
  • You can find the definitions of common terms and abbreviations in the glossary for injured workers.

You can also attend a free seminar on workers’ compensation or contact the Information and Assistance Unit if you have questions. You can also call 1-800-736-7401 for recorded information and the location of free DWC informational seminar for injured workers closest to you.

Our experienced attorneys can review your claim documents and outline the best possible options for you to get through the worker’s comp system quickly and strategically. We take the stress off your shoulders, and you can relax knowing that you have an experienced legal advocate representing your best interests.

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