Workers' Compensation

Do You Need an Experienced Workers' Compensation Attorney in the Sacramento area because you're overwhelmed with the process or are getting the run-around?

If so, we can help. Call us at 916-921-6400 or contact us online for a FREE, no obligation consultation.

Even as you read these words, you probably know someone dealing with a work injury. The effects can be devastating both financially and emotionally as an injured workers’ livelihood is placed on hold while he or she struggles to find his or her way through an extremely complicated system of benefits.

While the California Workers’ Compensation System was originally developed so that employees could not initiate lawsuits against their employers for negligence when injured, there are a number of areas today within the system itself that often require the assistance of an experienced workers’ compensation attorney.

Just below, we show the entire process that you'll go through - or are already experiencing. Take a close look so you can see what your up against - and why having a workers comp attorney can be a smart decision.

The 4 Stage Process of a Workers’ Compensation Injury and Available Benefits at Each Stage of the Process

  1. Injury
    • Medical Care
    • Medical Mileage Reimbursement (a monetary reimbursement for mileage to and from doctor appointments)
  2. Healing Phase
    • Medical Care
    • Medical Mileage Reimbursement
    • Temporary Disability (a monetary benefit that is two thirds of an injured workers’ average weekly wage with minimum and maximum caps)
  3. Post Healing Phase
    • Medical Care
    • Medical Mileage reimbursement
    • Permanent Disability (a monetary benefit expressed in a percentage. For example 52% permanent disability)
  4. Settlement
    • Medical Care
    • Cash Award
    • Vocational Rehabilitation (for injuries occurring before January 1, 2004)
    • Supplement Job Displacement Voucher (for injuries occurring on or after January 1, 2004

Few people can navigate the complexities of the workers’ compensation system by themselves.Because of the nature of their injuries and the experience of the insurance claims adjuster, most people need the assistance of a competent workers compensation attorney. The problems that occur throughout the four stages are varied and often complex.Some examples include:

  • an initial denial of liability for the injury,
  • failure to authorize medical care,
  • failure to pay temporary disability or pay it at the correct rate,
  • selecting the wrong medical legal evaluator for the assessment of permanent disability

When to seek a workers’ compensation attorney

First you must see if you are eligible for Workers Comp.
 
The business where you work must carry Workers Comp insurance (If they don’t, you have an uninsured employer case);
 
You must be an employee rather than an independent contractor. (And sometimes it’s not easy to tell);
 
Your injury has to be related in some way to your work. You don’t necessarily have to be at work, but it must be related in some way.

While an attorney can be of assistance throughout each stage of a work injury, to maximize the benefits to which you are entitled, it is imperative that you seek counsel prior to the selection of a medical legal evaluator. This is a doctor that is selected from a three member panel towards the end of the healing phase of an injury and offers his or her opinions on permanent disability.

Significant case law has developed within the last two years with respect to how permanent disability is assessed which greatly effects the injured workers’ final settlement. An insurance claims adjuster is not going to ask a medical legal evaluator to address this case law and how it affects your permanent disability. An experienced Sacramento workers compensation attorney can and will.

For more information and a free consultation contact us here or please call us at (916) 921-6400 or 800-404-5400.

We will not pressure you. We will not try to push you to retain an attorney. We will simply answer your questions - and ask you a few questions. Then you can decide if you need an attorney to help with your workers compensation claim.

Below are a few video’s to help you understand  how the somewhat complex California Workers Comp system works.

Temporary Total or Partial Disability  is when a doctor temporarily says you either can’t work at present or can only work under certain restrictions. The concept is very well explained in this video:


Permanent disability means you lose some portion of your functioning (Even 1 percent) from a work injury. This video is an excellent summary if you want to explore this concept further. A doctor will rate you using a Guide called the AMA Guide to Evaluation of Permanent Impairment:


Independent medical examinations:


The video above done by a San Diego attorney is an excellent summary of an IME or Defense Medical Examination which the insurance company’s doctor is entitled to do, once in your case. There are certain restrictions on these examinations. They must not be intrusive, invasive of your privacy beyond the medical issues you are claiming, and cannot be burdensome in terms of time.

When a nurse attends an IME exam, its always important to have her record the exam, time both the physical exam and history and note it the patient has difficulty follosing the doctors commands as well as note if the patient complains of pain.


The above video explains what are commonly thought to be reasons why it takes workers compensation claims so long to resolve. The truth, additionally, is that the workers comp insurers get interest on their money. Every single day, they delay your claim. Insurers will use any possibility to avoid paying claims.


The above video explains in some detail how attorney’s negotiate a compromise and release of an entire claim.  The injured worker may give up his or her right to future medical care and further claims of any sort in return for a lump sum payment.
Workers Compensation FAQ
What time of injury or illness is considered work-related for purposes of the California Workers Compensation System?

Any injury or illness can be work related. Often, however, the employee feels the injury or illness resulted from work while the employers representative try to pin the injury as arising from some other non-work related cause. The injured workers doctor’s opinion is very important when determining if an injury is work related. The doctor who examines you for the company, will often stat the injury is not work related. At that point, other doctors, biomechanics and even epidemiologists can add their opinions and ultimately the Administrative Law Judge assigned the case will make the final decision.

It is possible that an injury can be partly work related and partly not. In that case, the responsibility for the injury will be apportioned part to the current employed, possible part to past employers and possibly part to an outside of work cause.

Are Workers’s Comp benefits taxable income?

 
This is either a very simple or a very complicated question. The answer is usually Workers Compensation benefits are received free of Federal and State Tax.

However:
If  you receive Social Security disability benefits at the same time then part of your Workers comp benefits may be taxed.

If the combined amount of your WC (Workers Comp) and SSDI (Social Security Disability Benefits) is more than 80 percent of your “average current earnings” before you were disabled your SSDI benefits may be offset because of your receiving WC benefits. The amount your SSDI benefits were lowered is taxable cause your still receiving WC benefits.

However, if your single and make less than $25,000 yearly or married and make less than $32,000 there’s an exception and you won’t be taxed.

Let’s make it simple. Most of the time your WC benefits will not be taxed, and you are taxed, it won’t usually be for a lot of money.

I was injured on the job last week. How much do I collect from Workers Compensation for Temporary disability in California?

The amount you can collect in temporary disability depends on your wages at the time. If your injury happened after 1/1/15 here are some examples.

If your weekly earnings were below $248.24, then you would get $165.49 on temporary disability.
 
If you earned between $284.24 up to $1654.94 weekly you would get temporary disability of 2/3 of your average weekly earnings.
 
If you earned above $1654.94 weekly, you would get $1103.29 in temporary disability payments.

How Much Are Workers Compensation Attorney's Paid in California?

Attorney’s in California Workers Compensation cases work on a contingency fee basis. That means they only get paid if they win your case. The attorney fee is deducted from your settlement at the end of the case.

The most typical fee in California Workers Comp Cases is 15 percent of the award given. Fees are calculated on permanent disability benefits  and future medical treatment and temporary benefits where the attorney has had to fight to get the employer to pay up.
 
Sometimes fees can be lower in the 9 to 12 percent range. The percentage charged will be in the retainer you sign with the attorney and all fees in California must be approved by a Workers Comp Board judge. There is never a charge for the initial consultation.
 
In some “Penalty” cases fees may be up to 33.33 percent. “Penalty cases” are often where there is serious and willful misconduct on the part of an employer, where there is discrimination or where the employer unreasonably refuses or delays paying benefits.
 
In addition to fees taken out of your final settlement, attorneys also can get what are known as 5710 fees. These are fees paid directly by the employers insurance to the workers attorney for time spent defending the worker during his or her deposition.  The going rate insurers  pay is generally around $350 to $400 hourly for any time your attorney spends preparing you for traveling to or attending your deposition.

I’d like to know who the worker’s compensation insurer for my employer is. How can I find that out?
 
The Workers’ Compensation Insurance Rating Bureau (WCIRB) should have that information. If your employer is self- insured, you can find that out at Self Insurance Plans Web page.

If I file a California Workers Compensation claim, can my employer fire me?

An employer cannot fire you in California for the sole reason that you filed a worker’ s compensation claim or were injured on the job. Labor Code Section 132(a) would subject your employer to a lawsuit for wrongful termination should he do that and also for an action under FEHA (Fair Employment and Housing Act) and other Federal laws. Feel free to call me anytime if you feel you are being discriminated against or your job is in jeopardy because of filing a worker’s comp claim. I’m Ed Smith, a Sacramento Workers Comp lawyer at 916-921-6400.

Is there a good summary site that describes the entire California workers compensation system so that a layperson can understand it?
 
There is such a site that the State Workers Compensation Board wrote. It’s basic information and doesn’t spell everything out but it’s a good starting point.

What are Workers Compensation Rating Codes and How are they Established?

Workers Compensation Rating Codes are Codes established by the WCIRB Workers Compensation Insurance Rating Bureau of California.

This organization does research on the Workers Compensation Loss experience in most every industry. In other words, it will take an Industry such as the Roofing Industry (and try to break it down by sub components if possible) and research how often works employed in each code classification are injured and the amount of loss, on average for every industry group or subgroup.

Based on this research it will issue reports which describe each industry.

It will attempt to define certain jobs by their functions in the industry, and then issue a Code which when utilized with a multiplier helps find the sum the employer must pay in Workers Comp Insurance to cover the risk.

You can find the Database that classifies your job or industry at this site (www.wcirb.com/class-search).

Insurance premiums employer’s must pay in Workers Compensation Insurance are then derived from this.

Typically the premium per $100 that an Employer must pay for attorney’s (supposedly a low risk occupation) is .53 per $100 Earned.

An employer of someone engaged in Asbestos Abatement, on the other hand, will  pay $16.99 in insurance premiums for every $100 in wages paid..clearly a very risky occupation.

This database could (and should) be utilized by anyone planning to enter a given profession just so they can see objectively how hazardous a job it can be.

I need a workers compensation lawyer for my workplace injury but I have no transportation to get to the lawyer’s office. What can I do?

 
In most cases, we’ll figure out a way together. Either, I’ll send one of my employee’s to pick you up and bring you back or we’ll get a taxi to bring you here and back. If you’re immobile or are in a hospital, we’ll come out to see you if we can help. We’re here to please and do the best we can to help you on your worker’s comp case. After you visit with us, if you decide you don’t want us to handle your case or we decide we can’t help you, either way, you’ll share a cup of coffee with us and we’ll get you home.

How soon should I file a workers compensation claim if I am injured on the job?

If you are injured at work, you should inform your employer immediately. Your employer will give you a claim form and tell you how to get medical care. If you delay telling your employer

About you’re  on the job injury, you will delay your workers comp payments and in some cases, jeopardize entirely your ability to recover.

If you wait 30 days or more to report an injury you may be legally unable to collect California workers compensation benefits.

What’s the difference between SDI (State Disability Insurance) and Workers Compensation Benefits?

The difference is that workers comp pays weekly benefits when an injury or illness happens to you but it does not happen on the job. Workers compensation benefits happen when you have an injury at work. Workers comp pays weekly benefits (Temporary disability) also and additionally pays reasonable medical bills as well as retraining money if allowed by statute.

Sometimes someone may not know if an injury (For example, carpal tunnel syndrome) occurred from work or from something else. In those cases, file for both SDI and workers compensation.

I’m Ed Smith, a Sacramento Workers Comp attorney and would be glad to help you. Call me at 916-921-6400 in Sacramento and 800-404-5400 Elsewhere.
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