Definition Of A Workers Comp Injury
Generally speaking, there are two types of injuries:
1.) A Specific Injury is one which occurs as the result of one incident or exposure.
2.) A Cumulative Trauma/Injury is one which has occurred as repetitive motions or activities extending over a period of time, the combined effect of which causes any disability or the need for treatment. A Cumulative Injury also includes disease or occupational disease caused by employment.
Post Termination Claims
1.) The employer had notice of the injury prior to giving the Notice of Termination or Layoff to the employee.
2.) The employee’s medical records indicate an injury prior to the Notice of Termination or Layoff.
3.) The injury occurred after the date of Notice of Termination or Layoff, but prior to the effective date of the termination or layoff itself.
Date of Disability
It is important that an injured worker consult an attorney to determine the appropriate date of injury. It may appear that the one year statute of limitations has expired, but only if the worker can be charged with knowledge that this occupational disease or cumulative trauma injury was work related. The statute may not have expired and the claim may be valid.
Maximum Period Of Temporary Disability Benefits
However, an employee who suffers an injury involving hepatitis, an amputation, severe burns, HIV, a high velocity eye injury, chemical burns to the eyes, pulmonary fibrosis, or chronic lung disease may be entitled to a total 208 weeks (4 years) of temporary total disability.
Regarding Panel QME Reports
The injured workers’ lawyer must object to the report prior to its service in order for the report to be barred by Labor Code Section 4062.5.
Subsequent Injuries Benefit Trust Fund
Obligation To The Injured Worker
Workers’ compensation injuries in California are now determined based on the AMA guidelines. The whole person percentages in the Guides estimate the impact of the impairment on the individuals overall ability to perform Activities of Daily Living including the effects of the impairment on the ability to perform complex work and social activities. It is therefore important that the client keep his doctor advised and the lawyer about the effect the injuries are having on the clients’ ability to perform Activities of Daily Living. The lawyer should send the client an Activities of Daily Worksheet to complete so that it could be furnished to the treating doctor.
Reasonable Lawyer's Fees
A) Responsibly assumed by the attorney.
B) Care exercised in representing the applicant.
C) Time involved.
D) Results obtained.
The rules provide that a lawyer cannot except a fee from an injured worker until the fee has been approved or set by the Workers Compensation Appeals Board.
Identify Clients' Injuries
Under the new system, the injured worker has to treat with a primary treating doctor on the insurance companies Medical Provider Network in most situations. The only other doctor that the injured worker is likely to see is the Panel QME chosen by the State Panel list. Therefore, the primary treating doctor is extremely important and must insure that the injured worker sees all necessary specialists for any secondary injuries such as depression or anxiety in order for the issue of disability to be identified and established.
There should always be open lines of communication with the applicant’s attorney or lawyer so that the lawyer is kept advised of any new injuries that have developed. In many instances these injuries develop months or years after the industrial injury.
Make sure in your case that both the doctor and the lawyer identify your ability to perform Activities of Daily Living so that your permanent disability will be adequately addressed.
Out of State Injuries
My Commitment To You
As a workers compensation trial firm, we will endeavor to move your workers compensation injury case toward settlement or trial as soon as reasonably possible. We have been serving injured workers in California for over 30 years. Our firm has decades of trial experience. We are aggressive, knowledgeable and experienced. We will use this expertise to help maximize your recovery on your case. We handle only injury cases.
If you’ve been hurt at work you need an expert on your side. Contact us 7 days a week. Call 1-800-400-8321