Every state except Texas requires employers to carry workers’ compensation insurance. By California law, all employers operating in California with at least one employee must maintain workers’ compensation coverage for their employees. Workers’ compensation applies to any injury or illness, which occurs in the workplace as a result of work-related duties, allowing those injured at work to claim temporary disability benefits while they recover.
Employer Requirements When a Worker is Injured
Employers are required to provide employees with a safe place to work and to prevent injuries. If an employee is injured, an employer must complete a First Report of Injury form and send it to their workers’ compensation carrier. It is also the responsibility of the employer to ensure they do not violate any laws or rights of their employees. Employers are also required to cooperate with their workers’ compensation carrier, the insurance claims adjuster, and any workers’ compensation attorney who may be investigating the case.
What Work-Related Injuries are Covered By Workers’ Compensation?
While employers must provide a safe workplace for their workers, employees also have a duty to act responsibly while at work. In certain cases, workers’ compensation benefits will not be rewarded. Injuries and illnesses that are not covered by workers’ compensation may include:
- Injuries incurred due to intoxication or impairment
- Injuries due to knowing violation of a policy or code
- Horseplay or intentional misconduct
On the flip side, injuries and illnesses that are covered under worker’s compensation typically include:
- Medical expenses related to bodily injuries
- Lost wages during treatment and recovery
- Follow-up treatment
It is important to know workers’ compensation does not cover natural disasters such as earthquakes, tornadoes, or flooding. Civil disturbances and product liabilities are also not covered by workers’ compensation as those benefits are only applicable to injuries caused by the job itself or the job conditions. However, there are still legal options available to employees through a personal injury lawyer if they are unable to receive workers’ compensation benefits.
Medical Treatment Authorization Rights for Injured Workers in California
Each worker has an opportunity to use their own doctor if they were injured in a work-related accident, but only if the doctor’s identifying information was given to the employer prior to the injury. If there was no pre-designation of a primary treating physician before the injury, there are still certain exceptions in which you can still choose your own doctor. These exceptions include:
- If your employer did not post the required information about workers’ compensation rights and did not offer treatment after learning about your injury
- If your employer or claims administrator sends you for treatment that turns out to be insufficient or fails to give you care at all
If either of these scenarios applies, then it is recommended to contact a workers’ compensation attorney to ensure you get the proper care.
How Can an Attorney Help With Medical Treatment Authorizations?
A workers’ compensation attorney can help resolve disagreements about medical treatment. If you decide to challenge the medical treatment you receive or if you feel it is inadequate, an attorney can advocate on your behalf against workers’ compensation. The process will depend on whether you are being treated by a doctor within the Medical Provider Network (MPN) of workers’ compensation.
When going through workers’ compensation, you can get up to two more doctors’ opinions within the MPN. If you can’t reach an agreement with either of these doctors within 60 days, then a workers’ compensation attorney can help you arrange for an independent medical review with the California Division of Workers’ Compensation.
Contact a Workers’ Compensation Lawyer in California
If you or a loved one has been mistreated, neglected, or inadequately compensated by worker’s compensation or your employer after suffering a work-related injury, the workers’ compensation attorneys at Maison Law will pursue the full extent of the damages you are owed. Whether you’ve suffered permanent injuries, or have been denied medical treatment through worker’s compensation, our firm is prepared to exercise the full extent of the law on your behalf. For legal counsel concerning your workers’ compensation claim, contact Maison Law today for a free consultation and case evaluation.
