Frequently Asked Questions About Workers’ Compensation Law
- If the employer disputes my case what can I do?
- The employer has up to 90 days to investigate a disputed claim before either accepting or rejecting liability. How do I survive in the meantime?
- How long does temporary disability last?
- How are permanent disability awards determined?
- Am I entitled to a jury trial?
- How are attorney fees paid?
- Who pays for the medical costs?
- Can I sue for civil damages for a work injury?
- Can the insurance company follow me around and take pictures of my activities in order to disprove a claim?
- Can I recover money for my pain and suffering in a workers’ compensation claim?
- Do I need an attorney?
If the employer disputes my case what can I do?
You can appeal a denial of benefits to a workers’ compensation judge by filing (Attorney Brodie can assist in this) an “Application for Adjudication of Claim” and a “Declaration of Readiness to Proceed” to hearing before a judge. Before filing for a hearing you must have medical evidence.
The employer has up to 90 days to investigate a disputed claim before either accepting or rejecting liability. How do I survive in the meantime?
If the employer takes the full 90 days to decide whether to accept the claim, the injured worker can seek State disability benefits from the Employment Development Department (EDD) if you have paid into it. You must use your own health insurance while the 90 days are pending except the insurance company must pay for up to $10,000 in treatment while the claim is on delay.
How long does temporary disability last?
Temporary disability benefits will continue as long as the injured worker is off work and the continuing disability is supported by a doctor. Once the condition is permanent and stationary, the employer will end temporary disability. By law temporary disability may not last for more than 2 years from the date of first payment and this is true whether you return to work during the two year period and are off work again or it is continuous except for injuries after 1/1/2008 in which case the injured worker may receive two years of temporary disability within a five year period.
How are permanent disability awards determined?
For injuries after January 1, 2005, the permanent disability award is based on a book called the AMA Guides.
Am I entitled to a jury trial?
How are attorney fees paid?
Attorney fees in workers’ compensation cases are set by law and are generally 12% to 15% of the award and if there is no award or settlement, no fees are paid.
Who pays for the medical costs?
Under Workers’ Compensation Law, medical treatment is paid for by the insurance company and costs of medical evaluations such as QMEs are paid for by the insurance company.
Can I sue for civil damages for a work injury?
No. Workers’ Compensation is a no fault system ( see earlier paragraph).
Can the insurance company follow me around and take pictures of my activities in order to disprove a claim?
Yes. This is legal.
Can I recover money for my pain and suffering in a workers’ compensation claim?
No. See earlier paragraphs.
Do I need an attorney?
Yes. Workers’ Compensation Law is extremely complicated and you are at a distinct disadvantage against giant wealthy insurance companies who want to keep their money and not pay it to you. Call Attorney Brodie who can provide expert advice and assistance and get you the benefits you deserve. Don’t let giants like AIG take advantage of you.