Workers’ compensation is a valuable form of insurance coverage required by law for almost every private employer in Orange County, California. This insurance protects both employers and employees from the financial effects of workplace injuries. For employers, workers’ compensation insurance prevents them from facing liability for their injured employees’ damages. Injured employees are eligible to receive compensation for their medical expenses and lost income following an injury at work. Any worker who has been injured while performing their job can receive assistance from an Orange County workers’ compensation lawyer
Filing a claim for workers’ compensation benefits in Orange County, CA, may be similar to the process of filing any other type of insurance claim, but there are unique variables that all injured workers must acknowledge and prepare to address. You face an additional layer of complications because your employer will be involved, and almost every insurance carrier will attempt to fight any claim whenever possible. While it is technically possible to file your claim independently, you have a better chance of success with an experienced Orange County workers’ compensation attorney on your side.
Canlas Law Group has years of experience guiding Orange County clients through the workers’ compensation claim process. We know the challenges you could face as you seek compensation for your medical bills and the income you are unable to earn while you recover. Our team can help you make more informed decisions about every aspect of your recovery process, and you can rely on us to provide guidance and support if you encounter any unexpected obstacles between you and your benefits.
Most employees in the state are eligible for workers’ compensation, even if an employer only has one employee. However, domestic care workers, independent contractors, and certain other types of employment do not qualify for workers’ compensation and are exempt from employers’ policies. If you are unsure whether you qualify for workers’ compensation, your employer should be able to clarify the issue, but you should consult an Orange County workers’ compensation attorney to ensure your employer has properly classified the nature of your employment.
As long as you are a non-exempt employee in Orange County, you have the right to file a claim for workers’ compensation benefits if you are injured while performing your job duties. Remember that the timing of your injury is more important than location when qualifying for workers’ compensation. Many people do not work in a static workplace or are required to travel for work. If you are injured at work but are off the clock, this may mean you do not qualify for benefits, but if you are working anywhere outside of your usual workplace, you may still qualify as long as you were performing work-related duties when your injury occurred.
The state has some of the most robust workers’ compensation laws in the country as far as the conditions that qualify for benefits and the number of employees required to be covered by this insurance. Once you have suffered an injury at work, report the injury to your supervisor immediately. State law requires that they fill out an incident report that explains how and why your injury occurred, and they must provide you with the forms you will need to file your workers’ compensation claim.
If your employer interferes with your claim, or if they take any punitive actions against you for asking to file a claim in good faith, this is illegal retaliation and could form the basis of a separate employment lawsuit. Unfortunately, some employers will try to discourage their injured workers from filing workers’ compensation claims due to the expectation of their insurance premiums increasing. Others take more drastic adverse actions and engage in hostile retaliation, including wrongful termination. However, if they uphold their responsibilities, they will facilitate the filing of your claim.
As part of the claim filing process, you will need to undergo a medical evaluation by your employer’s insurance carrier-approved physician. This medical evaluation will result in a rating for your disability, reflecting your injury’s overall severity and the long-term or permanent harm you could experience because of it. The higher your rating, the more likely you are to receive disability benefits. If you don’t agree with the first doctor’s rating, you have the right to seek a second opinion.
After submitting your claim and receiving your disability rating, the insurance company will issue its determination of benefits if it decides that you qualify. Most injured workers in Orange County will receive two types of compensation: disability benefits and medical expenses. Workers’ compensation insurance generally pays for all medical expenses related to the treatment of a claimant’s injury, including immediate and future medical expenses if they need ongoing care.
Disability benefits are more variable. If a claimant can handle lower-paying work or lighter duty, they can receive partial disability benefits to offset the difference in earnings. They will need to provide updates on their recovery to the insurance company and report their income; otherwise, they could lose eligibility to claim further benefits. If the claimant cannot work while they recover, they will more likely get total disability benefits.
At a minimum, such benefits will include weekly payments equal to about 66% of the claimant’s average wage based on the year prior to the injury. So, if the claimant typically earns about $1,200 per week, they can expect roughly $800 in weekly disability benefits, and these benefit payments can go on for a maximum of 104 weeks. There are exceptions to this, and some claimants could qualify for benefits beyond the usual minimum requirements. Your Orange County workers’ compensation attorney is the most effective asset you have for maximizing your benefits determination.
California’s workers’ compensation laws typically prevent injured employees from suing their employers for their workplace injuries. However, exceptions to the rule exist. For example, if an employer does not have proper insurance coverage, then an injured worker would have the right to file a civil suit against them to seek compensation for their damages. Alternatively, if your work injury was the result of any third party’s actions, you would have grounds to file a personal injury suit against them along with your standard workers’ compensation claim.
Workers’ compensation insurance is an invaluable financial safety net for any injured worker in Orange County, but it is somewhat limited in terms of the compensation available. You cannot claim total compensation for all the damages you suffered as you could in a personal injury suit. A third-party personal injury claim effectively bridges this gap, enabling you to claim compensation for the damages that aren’t recoverable through workers’ compensation.
You may be able to recover the full amount of your medical expenses through workers’ compensation insurance, but the lost income compensation you receive will only be a portion of the total lost income you suffered from the incident. In your third-party personal injury suit, you can claim compensation for the remainder of your lost income as well as your pain and suffering. In California, there is no limit to how much pain and suffering compensation you can seek in a personal injury claim, so it could overshadow the rest of the compensation you obtain by a substantial margin if you suffered a catastrophic injury.
Ultimately, every injured worker will face different challenges as they seek compensation for their workplace injuries. The appropriate attorney is an invaluable asset who will make every part of the recovery process easier to manage, and it is more likely that you will secure maximum compensation for your benefits with their help.
When you choose Canlas Law Group to represent your workers’ compensation case in Orange County, you are investing in years of professional experience in workers’ compensation law. We have successfully represented many injured workers throughout Orange County, helping them secure the workers’ compensation benefits they deserve and assisting them in enhancing their recoveries whenever possible.
Whether you anticipate recovering suitable compensation through workers’ compensation alone or expect to file a third-party personal injury suit as well, we can help. Our team can assist you with the initial workers’ compensation claim filing process and verify that your employer has met all their legal obligations. We can ensure that your employer’s insurance carrier processes your claim in good faith and delivers a benefits determination that is fair under the terms of your employer’s insurance policy. If there are grounds for any further legal action, like a third-party personal injury claim, you can rely on us for assistance with this as well.
If you are filing a workers’ compensation claim, it can be helpful to know how much you might expect to receive during the process. The exact amount depends on a variety of factors, but the average settlement from a workers’ compensation claim in Orange County was $41,757 in 2020-2021, according to the National Safety Council.
The average amount is highly variable and is affected by the specific body part(s) that were injured and in what way the injury occurred. Injuries to the head, central nervous system, leg, neck, hip, thigh, pelvis, arm, shoulder, or multiple body parts receive more on average than injuries to other body parts. Injuries to the knee, face, ankle, abdomen, foot, hand, or chest receive less on average.
There are other factors that go into a settlement amount, including the severity and method of injury. For more information about your specific situation and how much you might receive in a settlement, discuss your claim with a workers’ compensation attorney.
Unfortunately, some workers’ compensation claims do get denied for several reasons:
In many cases of a claim denial, the individual can fight to get the claim approved, especially with legal counsel.
The first step to appealing a workers’ compensation claim in California is filing an Application for Adjudication of Claim form with the local office of the Division of Workers’ Compensation. Filing this form lets the department know that you want the claim to be revisited. If it is not successfully resolved at this stage, the case will be heard at a mandatory settlement conference.
If the case is not resolved at this conference, another court appearance is held by a different judge. Once the judge has heard both sides, they usually have up to 90 days to make a decision and will deliver it to you in writing. If you want to appeal the claim further, you must file a Petition for Reconsideration form.
Sometimes, the dispute is not about the claim getting denied but is about the type of injury or treatment stated on the medical report. In order to dispute this information, you must schedule an examination from a qualified medical evaluator to re-evaluate the report. This evaluation might prove that your injury is caused due to work actions, that you are permanently disabled, and what kind of treatment you need for your injuries.
If you receive an updated report from a qualified medical evaluator that you do not agree with, you can talk to an attorney for them to help you request a correction on the report. While it is not legally required to work with an attorney to appeal a workers’ compensation claim, it can be much easier to do so.
Most workers’ compensation benefits determinations that include ongoing disability benefits will continue for up to 104 weeks. However, the claimant has the option of spreading these payments out over a five-year term. Some claimants who have suffered severe injuries may qualify for an extension to their disability benefits, and permanent benefits are possible for those who have sustained catastrophic injuries that prevent them from returning to work. However, these benefits are very rarely awarded.
The average workers’ compensation claim will yield full compensation for all medical expenses associated with a workplace injury as well as ongoing disability benefits for the time the claimant is unable to work and earn income after their injury. The exact value of your impending worker’s compensation settlement will depend on the overall severity of your injury and your prior earnings before the injury. The amount you receive in weekly disability benefits is based on your average weekly earnings prior to the injury.
On average, most injured workers in Orange County start receiving their workers’ compensation benefits within a few weeks of filing their claims. However, this assumes that there are no disputes and that the insurance company handles the claim in good faith. If an employer interferes with a claim or if an insurance carrier unfairly denies a claim or offers an unreasonably low settlement, the case may take much longer to resolve.
It is technically possible to file your own workers’ compensation claim without an attorney, and you may succeed, but there are risks and challenges. You could make mistakes that delay your ability to collect benefits, or you could encounter resistance from your employer and/or their insurance carrier that are beyond your ability to handle yourself. Having an experienced attorney on your side can streamline your claim and maximize the benefits you secure.
Canlas Law Group takes workers’ compensation cases on a contingency fee basis. This means our client will pay only a portion of their total settlement as our firm’s fee if and when we win. There is no fee if we are unable to secure benefits for our client, and we carefully review our billing policy with each client we meet before any contracts are signed.
After a workplace injury, you deserve time to recover without fear of financial ruin. Canlas Law Group has successfully assisted many past clients with their workers’ compensation claims in Orange County, and we can put this experience to work for you. The sooner you reach out to our team, the more time we will have to work on your case and help you obtain the benefits you legally deserve. If you are ready to learn what our team can do for your impending case, contact us today and schedule a free consult with an Orange County workers’ compensation attorney.