Workers Compensation Lawyers

Whether you were injured by a traumatic event or a repetitive injury, workers compensation should cover your medical expenses and lost earnings. At Fontes Law Group we can represent you in dealing with the insurance carrier and defend your claim in court.

16 Steps of a Workers Compensation Lawsuit in California

No upfront fees, we only get paid if you do. Workman’s Compensation cases are handled on a contingency basis.

Our sophisticated, efficient, affordable, and client-centered services separate us from other firms as we help our clients achieve their goals.

Most people don’t consider the possibility that they could be injured at work. However, the U.S. Bureau of Labor Statistics (BLS) reports that nearly 2.7 million nonfatal workplace injuries and occupational illnesses were reported by private-sector employers in 2020 alone.[1] The BLS also reported another 4,764 workers were killed in workplace accidents during that year, a statistic that does not include fatalities caused by work-related illnesses.[2] The statistics demonstrate that workplace injuries and illnesses are much more common than many people might think. Because of the risks, California has instituted a workers’ compensation system to protect workers who are injured or sickened on the job.

Work-related injuries and illnesses can be physically, emotionally, and financially devastating. Under the workers’ compensation laws, employees can file claims for benefits through their employers’ workers’ compensation insurance carriers when they have been injured or sickened because of their jobs. In exchange for the availability of workers’ compensation benefits, employees are generally not allowed to file lawsuits against their employers unless an exception applies. If you or a loved one has suffered a workplace injury or illness, here is some information from the Fontes Law Group about workers’ compensation and some exceptions to the law that you should know.

 

California Workers’ Compensation Laws

All employers are required to provide compensation for employees who have been injured or sickened because of their jobs by either carrying workers’ compensation insurance or by securing a certificate of self-insurance from the Department of Industrial Relations under Cal. Lab. Code § 3700.[3] While some large corporations have sufficient revenues and profits to self-insure against workplace accidents and injuries, most employers in California instead participate by carrying workers’ compensation insurance. If an employer fails to carry workers’ compensation insurance, the employer can be convicted of a misdemeanor and be fined up to $10,000 for a first offense or $50,000 for a second offense under Cal. Lab. Code § 3700.5.[4]

California’s workers’ compensation system is a no-fault system. Under the law, employees can’t sue their employers in court for work-related injuries or accidents, but they can access workers’ compensation benefits. In exchange, employees also are not required to prove their employers were negligent before they will be entitled to benefits.

Types of Benefits Available Through Workers’ Compensation in California

The following workers’ compensation benefits are available to injured or sickened workers whose injuries or illnesses are related to their jobs:

• Medical treatment and related costs
• Temporary partial or total disability benefits
• Permanent partial or total disability benefits
• Job displacement/retraining benefits

Medical Care Benefits

Medical care for work-related injuries or illnesses must be covered under Cal. Lab. Code § 4600.[5] The medical treatment benefits must fully cover all related types of treatment for the injuries or illnesses, including hospitalization, acupuncture, surgery, chiropractic care, medical care, and others. It must also pay for the cost of any prescription medications, prosthetic devices, crutches, and surgical supplies. You do not have to use your private health insurance to pay for any of these costs. Instead, workers’ compensation benefits should cover them fully. However, your employer or its insurance company has the right to establish a medical provider network (MPN) through which you might be sent for treatment under Cal. Lab. Code § 4616.[6]

Medical care benefits also include the cost of transportation to and from your medical appointments or to pick up prescriptions. You are entitled to mileage reimbursement for your travel to attend medical appointments.

Temporary Partial or Total Disability Benefits

If your injury or illness temporarily prevents you from returning to work, you might be entitled to temporary partial or total disability benefits under Cal. Lab. Code § 4653.[7] These benefits pay 2/3 of your average weekly earnings until you are able to return to your job up to a maximum of 104 weeks. There is also a maximum amount of benefits based on a calculation the state performs each year. The payments will be made every two weeks under Cal. Lab. Code § 4650.[8]

Permanent Disability Benefits

Under Cal. Lab. Code § 4452.5, permanent disability benefits might be available if your injuries are disabling and permanently prevent you from returning to your former job. These benefits are calculated based on a disability rating scale. If you are determined to be less than 100% disabled by your injuries, you will be considered partially disabled.[9] If you are considered to be 100% disabled, you will be entitled to permanent disability payments for the rest of your life. If your disability is rated between 70% and 90%, you will be entitled to a life pension once your weekly disability payments end.

Job Displacement Benefits

If your injury prevents you from returning to your former job, you might also be entitled to job displacement benefits. This is a voucher for $6,000 that you can use for job retraining to learn a new type of job under Cal. Lab. Code § 4658.7.[10]

Workers’ Compensation Benefits for Surviving Family Members

If you are a surviving spouse or child of a worker who was killed in a work-related accident, you might be entitled to death benefits through your loved one’s employer’s workers’ compensation insurance coverage. Death benefits are available to surviving spouses and children, grandchildren, parents, grandparents, and others who were financially dependent on the deceased worker.

Certain family members will automatically be considered to be total dependents of the deceased worker, including children under the age of 18, a spouse who earned less than $30,000 during the 12 months before the worker’s death, and mentally or physically incapacitated adult children who can not earn an income because of their disabilities. Others will need to present evidence showing they were total dependents if they do not fall into one of these three categories under Cal. Lab. Code §§ 3501-3503.[10]

The total amount of death benefits available are based on the number of total dependents as follows:

• One total dependent – $250,000
• Two total dependents – $290,000
• Three + total dependents – $320,000

The death benefits are paid in installments similar to how temporary disability benefits are paid. Once the total amount has been reached, payments will continue for minor children who are total dependents until the last one reaches age 18.

Under Cal. Lab. Code § 4701, surviving family members can also recover funeral and burial expenses. These benefits will pay up to $10,000 for burial costs.[11]

Filing a Claim for Workers’ Compensation Benefits

You should immediately report a workplace injury to your supervisor or report it as soon as practicable. If you learn that your illness is related to your job, you should report it to your employer as soon as you find out. Your employer must provide you with a workers’ compensation form within one day of being notified. You will need to complete the employee section and include full descriptions of each area of your body that was injured. The employer must then submit the form to its insurer. The insurer will evaluate the claim and accept or deny it. If the insurer denies your claim, you have a right to appeal and should get help from an experienced workers’ compensation attorney at the Fontes Law Group.

What if an Employer Doesn’t Have Workers’ Compensation Insurance?

 

If you learn that your employer does not have workers’ compensation insurance, you can file a lawsuit against your employer under Cal. Lab. Code §§ 3706-3709.5 for both your personal injuries and the employer’s failure to carry worker’s compensation insurance. This is one of the exceptions to the prohibition against filing a lawsuit against your employer. Being able to file a personal injury lawsuit against your uninsured and negligent employer also allows you to pursue a broader range of damages, including the full payment of your lost earnings, non-economic damages, and punitive damages.

Third-Party Claims and Workers’ Compensation

If you were injured at work because of the negligence of a third party, you might be entitled to file a claim for worker’s compensation benefits through your employer and a lawsuit against the negligent third party that caused your accident and injuries. Third-party claims are common on construction sites where multiple subcontractors might be working simultaneously. For example, if you were struck by an employee of a different subcontractor while working on a construction site, you could file a workers’ compensation claim with your employer and a negligence lawsuit against the subcontractor company whose employee struck you. This can allow you to seek additional damages through your lawsuit for your physical pain and suffering, disability damages, and other non-economic damages that are not recoverable through workers’ compensation.

Independent Contractors and Workers’ Compensation

Independent contractors are not covered by workers’ compensation since they are not considered to be employees. However, if you are injured while working for an employer as an independent contractor because of the employer’s negligence, you will have the right to file a negligence lawsuit against the employer. This is another exception to the prohibition against filing a lawsuit against your employer.

Contact Our Workers Comp Lawyers Riverside or Workers Comp Lawyers Santa Ana

If you have suffered a workplace injury or have learned that your medical condition was caused by your work environment, you should speak to the experienced workers comp lawyers California at the Fontes Law Group. We have years of experience handling workers’ compensation claims and can help you understand your rights. Contact us today to schedule a free case evaluation.

References

[1] https://www.bls.gov/iif/
[2] https://www.bls.gov/opub/ted/2022/a-look-at-workplace-deaths-injuries-and-illnesses-on-workers-memorial-day.htm
[3] Cal. Lab. Code § 3700.
[4] Cal. Lab. Code § 3700.5.
[5] Cal. Lab. Code § 4600.
[6] Cal. Lab. Code § 4616.
[7] Cal. Lab. Code § 4653.
[8] Cal. Lab. Code § 4650.
[9] Cal. Lab. Code § 4452.5.
[10] Cal. Lab. Code §§ 3501-3503.
[11] Cal. Lab. Code § 4701.
[12] Cal. Lab. Code §§ 3706-3709.5.