YOUR WORKER’S COMPENSATION RIGHTS – GENERALLY
When it comes to injured workers, California laws provide certain rights and benefits to individuals who suffer a specific injury or cumulative injury on the job. We aggressively work on your behalf to help you obtain the benefits you deserve, which may include:
- Immediate medical care
- Weekly Temporary Disability Benefits
- Permanent Disability Compensation
- Lifetime Future Medical Treatment
Claims adjusters often deny treatment requests made by their own network physicians.
Claims adjusters use “Utilization Review” companies they choose to deny treatment requests, and there are very limited times to legally challenge these denials.
A Medical Provider Network (MPN) is a group of physicians hand-picked by the claims administrator to provide medical treatment. In certain circumstances, an injured worker may select his or her own physician, and usually this requires careful legal analysis.
NAVIGATING THE PROCESS
No one expects to suffer an injury while working, but when it does happen, securing quality medical treatment and wage replacement benefits quickly is essential. Unfortunately, the California workers’ compensation system has become a complicated maze of rules and restrictions that employers, insurance companies, and their army of attorneys use to their advantage. Unfortunately, the injured worker is often left to navigate the system alone, with many of their medical symptoms ignored, and worried about how their wages will be covered. Our firm recognizes this unfairness, and dedicate ourselves to guiding you through the process both in court, and seeking changes to improve laws for injured workers in Sacramento.
Our team has represented thousands of employees injured on the job, whether by a specific event, or due to the cumulative effects of a job over time. Mr. Martin is personally involved in every aspect of your claim, including continuous case evaluation, assembly of evidence, and court appearances.
Tom Martin has been an active leader in professional organizations for decades that seek to protect the rights of injured workers.
The “life” of a Workers Compensation Case
Every case is different, but there are some general pattern that they usually follow.
First, an injured worker’s rights include immediate care by a qualified physician (or team of physicians) who will evaluate and treat all consequences of an injury – not just the injuries an employer or insurance company are willing to recognize. Often, medical treatment is withheld by the claims adjuster while the claim is being “investigated”, even though the law requires payment of medical treatment up to $10,000 during the investigation. More often, insurance companies and their network physicians will only treat some of the injuries and ignore the rest. However, the law requires that all work related injuries and conditions be treated by the employer and its insurance company.
Second, your rights as an injured worker require that certain temporary wage replacement benefits (Total Temporary or Partial Temporary Disability benefits) be promptly paid by the employer’s claims administrator to you when a work-related injury or condition forces you to miss time from work. Often, insurance companies utilize physicians that return injured workers to work before they are fully able to.
Also, TTD / TPD is often paid at the wrong – usually lower – rate than what is legally owed.
Third, at the conclusion at the active treatment process, an injured worker’s rights include an assessment of all activities that have been permanently limited as a consequence of the injury or condition, and an award of permanent disability benefits based on the extent of those limitations. Sometimes, a vocation expert is necessary to assist in the assessment, particularly in career ending injuries.
Finally, there should be an assessment of lifetime future medical needs, and securing an Award from the Judge provided an advantage to securing them when needed.