In California as elsewhere in the U.S., workers’ compensation is the exclusive remedy available for a worker seeking money from an employer for lost wages and medical expenses due to a work-related injury or ailment. Unlike a personal injury case, a workers’ comp claim does not require the injured employee to prove that the workplace injury or illness was anyone’s fault. However, the extent of the injury and the amount of compensation sought are scrutinized by insurers in determining whether and how much to pay. At Goldschmid, Silver & Spindel, our experienced workers’ comp attorneys will negotiate on your behalf and protect your interests so the insurer pays what it should.
A notice of claim for workers’ comp benefits generally must be filed with your employer within 30 days of a work-related injury, though different time computations apply in cases of cumulative trauma injuries or occupational diseases. After giving notice, you have as long as a year to file the actual claim. When that is submitted, your employer’s insurer must authorize payments for medical treatment while the claim is investigated. In the meantime, the insurer is responsible for up to $10,000 in medical bills. If you have to miss work because of your injury or illness, the insurance company should begin paying temporary benefits within 14 days after it receives notice. The insurance company has 90 days to approve or reject your claim or you will automatically be entitled to benefits.
Claim disputes and denials must follow procedures and deadlines set by law, including adjudications hearings and appeals that are best handled with the aid of a qualified workers’ compensation attorney.
The amount and duration of workers’ comp benefits are different depending on whether you are temporarily or permanently disabled and whether the disability is total or partial.
You are considered temporarily disabled if your doctor concludes that your work-related injury or illness prevents you from doing any part of your job for a length of time. Payments begin after you have missed three days of work or if you have been hospitalized. Temporary disability payments replace only about two-thirds of your average weekly pre-tax wages at the time of your injury, including overtime, the market value of job perks and wages from other jobs. You can receive temporary disability benefits for up to 104 weeks in a five-year period.
Permanent disability benefits are payable if your doctor determines your recovery will not improve in the next year. Total permanent disability benefits are payable if your doctor determines that you are unable to work in any capacity for the rest of your life. Partial permanent disability benefits are payable for disabilities less than 100 percent, based on these rating factors:
The amount of weekly total and partial permanent disability payments may be similar, the rating percentage impacts how many weeks the payments last.
Assessing all of the factors that impact your impairment rating, negotiating with your employer’s insurance company and resolving disputes is complex. An experienced workers’ compensation lawyer from our firm can help you navigate the system and obtain the benefits you deserve.
With more than 150 years of combined workers’ comp experience, Goldschmid, Silver & Spindel is a strong advocate for injured employees. We accept workers’ compensation cases on a contingent fee basis: we only get paid if we get your benefits approved. To learn more about how our firm can help you, schedule a free consultation by calling 213-251-5900 or contacting our Los Angeles office online.