In many instances, you get hurt on the job, miss a few days of work, and then are ready to return. That’s not always the case, however, as some injuries are more severe, and some are not covered at all.
If you became ill or injured at work, or because of your work, you usually are entitled to workers’ compensation benefits. These benefits include payments for medical bills, some recovery costs, and usually lost wages. If you’re eligible, you may receive compensation regardless of who was at fault for the injury. In exchange for this insurance protection, you commonly lose the right to file a lawsuit against your employer for damages that are not covered by workers’ comp.
A few of the most common injuries usually covered by workers’ comp claims are:
- Strains & Sprains – The most common injuries for which you may have a workers’ comp claim are sprains and strains. Sprains and strains are damage to your muscles or connective tissues. They are particularly likely to occur in the manufacturing, moving, and warehouse industries, but can happen in almost any setting.
- Cuts and Punctures – Cuts and punctures commonly are due to handling materials or tools that are required for your job. Cuts and punctures are common injuries in the construction, manufacturing, and retail industries. You can also receive them in work-related traffic accidents, etc.
- Fractures – Broken or fractured bones are caused by falls, impacts with objects or equipment, equipment malfunctions, traffic accidents, and falling objects. These can be severe, and sometimes put you out of work for months or years.
These are only examples, but there is a myriad of injuries reported each year that qualify for workers’ comp, such as:
- Electric shock
- Brain injuries (even TBI’s)
- Hearing loss
- Dental and jaw injuries
- Harm or loss of vision
- Organ damage
- Mental health problems, and more.
What Other Rules May Qualify Me For Workers’ Comp in California?
In California, commonly there are four basic eligibility requirements for workers’ comp benefits, they are:
- You must be an employee at the time of the injury.
- Your employer must carry workers’ comp insurance.
- Your injury or illness must be work-related.
- You must meet your state’s guidelines and deadlines for reporting your injury and filing your workers’ comp claim.
There are a few special rules for some categories of employees, which include domestic workers, agricultural and farm workers, casual or seasonal workers, and workers placed with an employer by temporary agencies.
What Injuries May Not be Covered By My Workers’ Comp?
Generally, if your injury occurred at your workplace or by doing your job, you should be covered under California’s workers’ comp insurance laws. It’s particularly important to note, that if your injury happened while you were working or performing work-related activities, you usually will be able to obtain financial compensation for your medical expenses and a portion of your lost wages. However, other factors that can impact whether you are entitled to these benefits.
As an example, the severity of your injuries can have a definite impact on your potential workers’ comp claim. Most of the time, workers’ comp is used for workers who have sustained serious injuries. So, if you’ve been injured and can be treated promptly with a simple first aid kit, or simply have minor bruises or cuts, then you may not be eligible for workers’ compensation benefits.
Where your accident and injury happen will not have an impact on whether you can receive workers’ compensation benefits. There are exceptions, or “grey areas” that workers’ comp insurance companies can use to deny claims. A valid example of this is an injury or accident on your commute to work. While your commute is related to work, it is not viewed to be within the course and scope of your employment.
Remember, that workers comp insurance companies usually only pay when they must, and as little as they need to. If you believe that your injury has not been handled justly, or if your employer tells you you’re not eligible for workers’ comp, consult with a Riverside workers’ comp lawyer as soon as possible. Your lawyer will go over the details of your case, and their expertise will be invaluable in getting the financial help you need so you can recover fully.
My Injuries Are Not Being Covered By Workers Comp, Can I Dispute This?
If you have suffered a work-related injury and there’s a disagreement regarding whether your injury should be covered under workers’ comp, you have the right to challenge the decision. This denial could be from the fact that the injury is not work-related or for many other reasons.
When this occurs, you have the right in California to have an evaluation performed by a qualified medical evaluator, file a case at one of the Division of Workers’ Compensation offices, and file an application for adjudication of your claim. Your workers’ comp lawyer will request a hearing before a judge, and usually file a declaration of readiness to proceed.
At your hearing, you, as the injured employee and the claims administrator appear before a judge to discuss the settlement of your claim. If the settlement is not to your satisfaction, then your workers’ comp lawyer will commonly have it scheduled for trial.
In this type of case, your Riverside workers’ comp lawyer will be invaluable in disputing the case and be prepared to provide adequate documentation and evidence of your injuries. If you’ve been injured in a workplace accident and were denied compensation, you, and your family, could spend thousands of out-of-pocket dollars that workers’ comp should be responsible for. Your workers’ comp lawyer has the expertise, negotiating skills, and knowledge that will assist you to resolve your case in your favor.
I Believe My At-Work Injuries Should Have Been Covered by Workers’ Comp, How Should I Proceed?
If you’ve been injured on the job, especially seriously, then you and your family’s future could be in the balance. There are many workers’ comp cases that are legally complex and may be tricky to determine exactly what kind of compensation you are eligible to receive. The Accident Network Law Group has the experience, knowledge, drive, and negotiating skills, to help you with your workers’ comp claim so that you receive the compensation you need and deserve. Don’t try this alone, as you and your family’s future may depend on the outcome.