If you’re injured on the job in California, you probably qualify for workers’ comp benefits to cover your medical bills and partially replace your lost wages, but you may need assistance to obtain your benefits and treatment. A San Rafael workers’ compensation attorney can help.
What types of benefits are provided through the workers’ comp system? What treatment is provided? Will your personal doctor be allowed to treat your workplace injuries? What else should you know regarding workers’ compensation?
If you’ll keep reading this brief introduction to workers’ compensation, you will learn the answers to those questions, and you’ll learn more about your rights as an injured worker in California.
What Are Your Workers’ Compensation Rights?
All California employers must purchase workers’ compensation insurance. When an employee sustains a work-related injury or illness, the employer’s insurance company pays for the medical care, lost wages, and if necessary, for vocational retraining or permanent disability benefits.
If you are employed in California, your workers’ compensation rights include your rights to:
1. submit a claim after a job-related injury
2. receive prompt medical treatment
3. have a medical exam conducted by a doctor who is not your employer’s doctor
4. benefits based on your particular injuries
5. protection from wrongful termination or any other employer retaliation
Workers’ comp in California offers four types of benefits to injured employees: temporary disability benefits, medical benefits, permanent partial disability benefits, and help with vocational retraining.
Temporary Disability Benefits
Temporary disability benefits total two-thirds of an injured worker’s average weekly wages, up to a cap set by law each year. Temporary disability benefits are granted when a doctor states that a worker can’t work temporarily due to an on-the-job injury.
An injured worker is entitled to temporary disability benefits until he or she is approved by a physician to go back to work or until the employee’s condition reaches “maximum medical improvement,” when the condition has stabilized and will no longer either improve or decline.
Medical Benefits
Injured workers in California are also entitled to all reasonable and necessary medical care and treatment for job-related injuries, and workers’ comp pays for that treatment.
Permanent Partial Disability Benefits
When a recovering injured worker reaches maximum medical improvement, if a doctor determines that the work-related injury was the cause of a permanent impairment or disability, the worker may receive permanent partial disability payments.
Permanent disabilities are rated on a scale of zero to 100 percent. With a 100 percent or total disability rating, an injured worker is entirely and permanently unable to return to work.
Vocational Retraining
When an employee can’t return to his or her job after a workplace injury, but that employee may be able to work in another capacity, the employee may be eligible under workers’ comp for vocational rehabilitation and retraining assistance.
Can You Be Treated By Your Own Doctor?
Many employers in California and their workers’ comp insurance companies have established MPNs (medical provider networks) to deal with job-related injuries. If your employer uses an MPN, workers’ comp typically requires you to be treated by those medical providers.
Under workers’ compensation, to be seen by your own doctor or by any healthcare provider outside of the medical provider network, you must name or “pre-designate” the doctor before a job-related injury occurs, and you can only pre-designate if:
1. You complete the paperwork for pre-designation and tell your employer that you are pre-designating a doctor.
2. The doctor you name agrees to see you for job-related illnesses and injuries.
3. The doctor has seen you previously and has your records.
What Are A Medical Provider Network’s Obligations?
As previously mentioned, most employers in California and their workers’ comp insurance companies have established MPNs. Unless you pre-designate a specific doctor, a job-related injury will be handled by a doctor in your employer’s or employer’s insurance company’s MPN. You may later change your doctor within the medical provider network if you wish.
Determining the exact benefits and rights that injured workers may be entitled to under workers’ compensation isn’t easy. The guidelines and regulations are exceedingly complicated and detailed.
Moreover, many employees in California who sustain work-related injuries may not be sure if they are eligible for workers’ comp benefits, and some don’t understand how to file a workers’ compensation claim.
How Will A Workers’ Compensation Lawyer Help You?
In San Rafael or anywhere in the San Francisco Bay Area, if you are injured at work, seek advice and guidance from a San Rafael workers’ compensation attorney. Workers’ comp lawyers handle the most difficult cases. They know what it will take to obtain the benefits you deserve and need.
Navigating the workers’ comp system in this state can be a frustrating and challenging process – especially if you’re still recovering from a serious injury or illness.
If you want to ensure that you will be treated by your own doctor after a workplace injury, tell your employer and complete the paperwork to pre-designate that doctor. Otherwise, you’ll be required to use MPN doctors.
If You’re Injured At Work, What Steps Should You Take?
If you’re injured at work, you have two immediate priorities. Your first is immediate medical treatment. After you’ve been treated, arrange to meet with a California workers’ compensation attorney.
The right workers’ comp attorney will know the rules about pre-designation and will fight aggressively to help you obtain the medical care and services you need – whether it’s inside or outside a medical provider network.
Work from the start with a workers’ comp lawyer who knows the system. Consulting a lawyer at the very beginning ensures that your workers’ comp claim will be error-free. Otherwise, your benefits may be delayed or even denied entirely.
If you’ve sought worker’s comp benefits and your claim was rejected, a workers’ compensation lawyer can appeal that decision. The workers’ compensation bureaucracy is huge in California. You must be represented by a lawyer who knows the bureaucracy and works with it regularly.
And if you’re having problems now with a workers’ compensation claim that you’ve already filed or with a medical provider network, it’s not too late to speak with an attorney. Your health and your future are too important to risk.