When you’ve suffered a work-related injury or contracted a work-related illness, you have the right to obtain workers’ compensation benefits for those injuries or illnesses. At the Law Offices of Todd R. Tatro, we specialize in Workers’ Compensation Law, and we have both experience and expertise on our side when it comes to handling workers’ comp cases. His firm represents only injured workers and not employers or their workers’ compensation insurers.
Workers’ Compensation claims can arise from many situations. Workplace accidents and injuries, car accidents while driving a company vehicle or possibly your own vehicle for business purposes, chemical exposure, and repetitive stress injuries are just a few of the types of accidents and physical injuries that are common in workplaces in and around the Fresno area, and throughout California. There are also several psychological injuries that can occur at work, such as mental abuse from colleagues or bosses, or worrying and stress caused from working in known unsafe conditions, or that arise out of the workload itself and/or related to the work activities you perform.
There are five potential benefits provided to employees by workers’ compensation insurance if they qualify for such due to their industrial injuries. They are:
Medical care is the treatment that is paid for by your employer or their insurer when you’ve suffered an injury or illness that is workplace-related. Generally, this is medical treatment that is reasonably necessary to cure or relieve the effects of the industrial injury. However, such treatment is usually subject to the defendant’s Utilization Review (UR) process, and if denied, may require Independent Medical Review (IMR) to address the injured worker’s entitlement to the recommended treatment if they are interested in trying to receive the treatment.
These are payments that you will receive if you lose wages because you are temporarily unable to work due to your workplace-related injuries based on a physician’s opinions. If you are released to modified or light duty with restrictions prior to becoming Permanent & Stationary (also referred to as P&S) or reaching Maximum Medical Improvement (also referred to as MMI) and your employer does not have any work consistent with the restrictions given or only has work for a limited number of hours, you may still be entitled to temporary total disability benefits (if no work is available within the restrictions) or temporary partial disability benefits on a wage loss basis (if work is available for fewer hours or at a lower rate of pay than you were working for at the time of injury).
If you are unable to completely recover from your injuries after a period of time has past for treatment and healing and your condition has stabilized (reached a P&S/MMI status) and you are found to have a permanent impairment/disability that affects your activities of daily living and/or ability to work, or if you are found unable to work, you generally would be entitled to receive permanent disability payments. However, the amount of such benefits and duration of any permanent disability payments you might be entitled to receive for your injuries if you qualify, would depend on the level of permanent disability ultimately found.
If you were injured in 2004 or later, and you are found unable to return to your usual and customary employment due to your industrial injury and your employer does not have modified or alternative employment available that meets certain requirements, you may be entitled to a voucher from the employer or their workers compensation insurance carrier that will help you receive retraining and skill enhancements need to find a different job. For injuries that occur on or after January 1, 2013, along with the Supplemental Job Displacement benefit referenced above, the State of California has also set up a Return-to-Work Supplement Program (RTWSP) from which you might also be entitled to benefits. The application for this one time supplemental payment is available online at: (http://www.dir.ca.gov/RTWSP/RTWSP.html).
In the event that a life is lost due to a workplace-related accident or injuries, the decedent’s spouse, children, or other dependents may be entitled to receive workers’ compensation payments in the form of a death benefit.
In California, when you’ve been injured on the job, the first thing you should do is report any injuries to your immediate supervisor. This is critical, as any delay in reporting your injuries could be interpreted as your not being injured enough to file a claim or could put into issue whether you were really injured on the job. The next thing you should do is consult an experienced workers’ compensation attorney. Todd Tatro is such an attorney, who offers free initial confidential consultations with absolutely no obligation. He can help assess the strength of your case and any issues involved and if retained can also help you follow all proper procedures, including the filing of any necessary documents to secure your workers’ compensation claim and to try and protect any rights you might have to benefits. Remember: any delay in reporting your injuries will be held as a negative against you, so it is imperative that you report your injuries immediately after they occur.
By California law, your employer has one day (24 hours) in which to provide you with a claim form after learning about your workplace injuries or illness. If you fail to obtain one of these forms from your employer, you can secure one of them at the Law Office of attorney Todd R. Tatro. If you can not get a form from your employer, or they fail to document or acknowledge the injury, it may be an indication that your employer will be less than cooperative when it comes to your workers’ compensation claim, or it could be an indication that they may not have workers compensation insurance coverage. Again, your attorney can help you through this process and with evaluating our options if your employer proves to be less than responsive.
Of course, if emergency medical treatment is needed, that should be your first priority. It may be that your employer will suggest a place for you to go to get treatment, but the priority is on you receiving the treatment you need. When you do receive treatment, it is imperative that you advise the medical personnel that your injuries or illness is job-related, and advise them of all of the areas or body parts injured. This makes an enormous difference in the paperwork that they complete on their end, and also who they ultimately bill for payment of the medical services rendered.
Once you (or your attorney) obtain, fill out, and submit your workers’ compensation claim form, several actions are put into motion. Officially, you have stated that you have suffered a work-related injury or illness. Generally, your employer has 90 day time frame within which to accept or deny your claim. However, if they do not accept or deny the claim within 90 days after your providing the completed claim form to your employer, the case is presumed to be compensable. At that point, the presumption would limit defendant’s ability and what evidence they can use to try and later deny your claim after that 90 day time period. If your claim is put on delay, you would still in most cases be entitled to receive medical treatment for your industrial injuries at a cost of up to $10,000 while a claims officer reviews your claim. If you submit your claim form promptly and your claim is accepted, it may also increase the disability payments you’re entitled to if the insurance company or your employer is late in making any payments due to you.
Attorney Todd R. Tatro can assist you in working on receiving the medical treatment you need to treat your injury or illness. By California law, all treatment recommended and provided must be “evidence-based,” meaning that it must be scientifically proven or accepted medically to treat, cure or relieve the work-related injury or illness that you suffer from. In this regard, there are distinct guidelines that medical providers must follow addressing which treatments are effective for which injuries, the frequency, intensity, and duration of treatments given and they must provide the needed information in their medical reports to increase the chances of your getting the needed treatment approved. Such information can also help with the appeals process if the recommended treatment is denied. This can all seem very overwhelming, and Attorney Tatro can assist in guiding you through each step.
Even if you are working or being classified as an independent contractor, depending on the factors involved, it is possible that you may still be eligible for workers’ compensation if you’re injured on the job. Ordinarily, independent contractors aren’t covered by workers’ compensation laws, but there are various issues that labor law enforcement agencies, courts, and workers’ compensation attorneys will look at and evaluate to assist in determining whether or not you are an employee or actually an independent contractor. It’s possible that the employer has misclassified you to avoid paying their workers’ compensation responsibilities. So, even though you may technically be working in an independent contractor capacity, this doesn’t necessarily always mean that you aren’t covered under workers’ compensation laws.
The smartest thing you can do if you’ve been injured or contracted an illness that is work-related is to contact the Law Office of Attorney Todd Tatro. He can review your situation to help you navigate through the rules, regulations, procedures, and laws regarding your potential workers’ compensation claim and your actual status. Attorney Tatro will fight to try and make sure you receive every dollar of compensation that you’re entitled to in your case. Contact his office today for a free, initial no-commitment consultation at (559) 431-0123, or through his online contact page.