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David Huete

Workers Compensation Attorney

Huete Law

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What is worker's compensation insurance?

Every Californian employer with one or more employees must have worker’s compensation insurance to cover the cost of worker’s compensation benefits. These are awarded for eligible injuries to cover medical expenses and lost income, regardless of who was at fault for the accident which led to the injury. Employers must prominently display details of their worker’s compensation insurance in their properties, and there are serious consequences for employers who are uninsured.

What does worker’s compensation cover in California?

In general, worker’s compensation will cover any injury sustained while doing something for your employer as part of your employment. This includes accidents which occur on a business’s premises, as well as off-site if an employee was there due to their employment (for example, a salesperson meeting with a client for a business lunch).

When a worker suffers a workplace injury, worker’s compensation will cover expenses for:

  • Medical treatment & rehabilitation
  • Disability benefits – to cover lost wages while recovering from an injury
  • Vocational benefits to retrain if a workplace injury causes you to lose your livelihood
  • Death benefits

If an employee’s injury has been caused by their own serious and willful misconduct, California law says that the benefits to be paid will be reduced by half. However, this rule doesn’t apply if:

  • The injury results in death, or a permanent disability of 70 percent or over,
  • The injury is caused by an employer’s failure to comply with any law or safety order, or
  • The employee is under 16 years of age when they are injured.

Can I work while receiving worker’s compensation?

If you return to employment on a salary that is the same or higher than before your injury, it is likely that worker’s compensation benefits will stop. However, worker’s compensation can cover a drop in earnings if a workplace injury negatively affects your earning potential. Medical expenses related to the effects of a workplace injury can still be covered after returning to work.

What is the process for claiming worker’s compensation after a work injury in California?

If you are injured while working, you should report the injury to your manager or supervisor in writing within 30 days. Your employer must provide you with a worker’s compensation claim form within one day of reporting the injury. You should also see a doctor about the injury as soon as possible.

A claim must be submitted within one year of the injury which caused the disability. Once you have submitted a claim form for worker’s compensation, your employer should submit this to their worker’s compensation claims administrator. They should also authorize up to $10,000 for necessary medical treatment. Speak to an Experienced Worker’s Compensation Attorney Today!

This article is intended to be helpful and informative. But even common legal matters can become complex and stressful. A qualified worker’s compensation lawyer can address your particular legal needs, explain the law, and represent you in court. Take the first step now and contact Huete Law Office to discuss your specific legal situation.

FAQ's

Yes, California law requires all employers to have coverage for their California employees. An employer can buy it from a licensed insurer. They can also choose to self-insure, if they meet the requirements set by the Department of Industrial Relations (DIR).

It is a criminal offense for an employer to be unlawfully uninsured regardless of whether or not an employee is injured. California Labor Code Section 3700.5 specifies that it is a misdemeanor punishable by either a fine not less than $10,000 or imprisonment in the county jail for up to one year, or both. In addition, the state issues penalties of up to $100,000 against illegally uninsured employers. If an employee is injured, the employer is responsible for paying all benefits and may be subject to additional liability.

Generally, insurance is optional for any business where the only employees are owners of the business. Consult your insurance agent or your attorney for your options.

Some employers, mainly large businesses, may opt for self-insurance if they are authorized to do so by the Department of Industrial Relations (DIR). Self-insured employers remain liable for all workers’ compensation claims. See Labor Code Section 3700 et. seq. Contact your insurance agent or the state’s Office of Self-Insurance Plans.

Determining whether or not you are covered by workers’ compensation can sometimes be complicated. Generally, there are two main factors that determine your status: first, whether you are an employee, and second, whether your injury occurred as a result of your employment. It should be noted that neither of these factors is an absolute guarantee that you will be covered by worker’s compensation. For example, depending on the rules in place in your state, some employees (such as agricultural workers) are not covered by worker’s compensation. Also, if you were intoxicated at work or intentionally injured yourself, you might not be covered by worker’s compensation. When in doubt, you should contact an experienced worker’s compensation attorney, who can advise you of your rights

The answer to this question is “maybe.” If the return to work enables the employee to receive wages equal to or greater than he or she was earning prior to the injury, then it is likely benefits will be stopped. If, however, the employee is still experiencing a wage loss due to his or her injury, he or she may continue to receive wage loss benefits, although the benefits will most likely be for a lesser amount.

No. Although most injuries are covered by worker’s compensation, that does not mean that employees have free reign to injure themselves, or act in any manner in which they choose, and then collect benefits. Generally, if an employee sustains injures as a result of intoxication or illegal drug use, benefits may not be payable.

The answer to this question will depend on the laws in your particular state, and the facts of the specific case. Generally speaking, if the injury “arises out of” and occurs “within the scope of employment,” it is covered. For example, if an employee is a traveling salesperson and is injured in the hotel where he or she is staying for business purposes, compensation may be appropriately paid.

Similarly, if an employee is running an errand that takes him or her outside of the workplace, at the request of the employer, compensation benefits may be payable if an injury occurs in the course of running that errand. If the employee is on a business errand, but has stopped or deviated from that errand for personal reasons, then a closer examination of the rules and facts is necessary.

Finally, employees injured while attending an employer-sponsored recreational event, like a company picnic or outing, may be able to receive worker’s compensation benefits even though they were not physically on the employer’s premises at the time of the injury.

It’s not often necessary to file a lawsuit against your employer for workplace injuries, and it may in fact disqualify you from collecting workers’ compensation benefits. But it never hurts to speak with an attorney if you have questions about your injury, whether it’s covered, what is considered reasonable compensation, etc. Contact David Huete’s Office today!.

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David Huete

Workers Comp Attorney

If you have been injured on the job, the most important thing for you to do is to report the incident to your employer and get the medical treatment that you need. The next step is to contact an attorney experienced in handling workers’ compensation matters so you can understand all of your rights and obligations related to filing for workers’ compensation.

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