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Workers’ Compensation Benefits

Worker’s Compensation insurance is designed to provide six basic benefits:

☛ Medical Care. Paid for by your employer to help you recover from an injury or illness caused by work
☛ Temporary disability benefits. Payments if you lose wages because your injury prevents you from doing your usual job while recovering.
☛ Permanent disability benefits. Payments if you don’t recover completely.
☛ Supplemental job displacement benefits. Vouchers to help pay for retraining or skill enhancement if you don’t recover completely and don’t return to work for your employer
☛ Death benefits. Payments to your spouse, children or other dependents if you die from a job injury or illness.
workers comp word cloud
Even though workers’ compensation benefits are designed to provide you with the medical treatment you need to recover from your work related injury or illness, partially replace the wages you lose while you are recovering, and help you return to work. The insurance carrier often denies or delays your workers compensation benefits. An experienced workers compensation attorney can assist you with an aggressive pursuit of your workers’ compensation benefits, your rights and responsibilities so you get the benefits you deserve.

In addition to Workers’ Compensation Law, an injured worker may be entitled to other rights depending on the circumstances. This might include:

1. Third Party Cases

Usually the only remedy an injured worker has against an employer is Workers’ Compensation Law, and negligence is irrelevant. However, if the injury is caused by a third party, someone other than the employer or an employee, then the injured worker may have a workers’ compensation claim and a civil claim. For example, if you are driving a truck for your employer and you are rear-ended by another driver, you may have a claim against that other driver in addition to your Workers’ Compensation Claim. Attorney Bruce Gelber networks with other legal specialists to ensure the maximum recovery for his clients.

2. Uninsured Employer Cases

California Workers’ Compensation Law requires that all employers provide workers’ compensation insurance for their employees. If a worker is injured while working for an uninsured employer, then the injured worker can sue the employer for civil damages in the civil courts in addition to claiming workers’ compensation benefits. The injured worker, in many circumstances, may be able to obtain benefits from a state agency called the Uninsured Employers Fund.

3. Intentional Injuries

If the injured worker is the victim of an intentional injury, such as when the boss attacks you, then the injured worker may sue the employer in civil court in addition to claiming workers’ compensation benefits.

4. Discrimination

California law prohibits an employer from discriminating or retaliating against an injured employee because he or she has made a claim for workers’ compensation benefits. Claims for discrimination most often end up before a workers’ compensation judge. The penalties for unlawful discrimination by an employer against an injured worker due to a work injury include lost wages, reinstatement, and a penalty of up to $10,000.

5. Serious and Willful Misconduct

While Workers’ Compensation Law does not allow the injured worker to sue the employer for negligence, if the Injury was caused by the serious and willful misconduct of the employer, additional penalties may apply against the employer, of a 50% increase in workers’ compensation benefits. Serious and willful misconduct can be found if the employer had advance notice of a dangerous condition but did nothing to remedy the situation and the employee was injured as a result of the employer’s failure to act on the dangerous condition. Advance notice is usually an important consideration. Serious and willful misconduct may also be found if the employer violates California Safety Orders leading to the work injury, but again, serious and willful misconduct is different and distinct from negligence or even gross negligence on the part of the employer.

6. Social Security Disability

If a person is disabled or likely to be disabled for a year or more, he or she may be entitled to Social Security disability benefits if you have paid sufficient payments into your Social Security account. To obtain Social Security disability benefits, the disabled person must show that he or she is disabled from gainful employment, not just your usual and customary job. The Social Security disability claims are administered by the Social Security Administration and often require hearings before Social Security Administrative Law Judges. In serious cases, Attorney Bruce Gelber can recommend attorneys for Social Security disability benefits.

7. Reasonable Accommodation

work-accidentThe Americans With Disabilities Act (ADA), a federal law and the Fair Employment and Housing Act (FEHA), a state law, mandate that an injured worker or disabled person be reasonably accommodated by an employer if the modification or accommodation does not create “undue hardship” on the part of the employer. If the disabled person believes that the employer can accommodate or modify the employment so as to allow a return to work but refuses to do so, the worker may bring a claim in civil court under the ADA or FEHA in the appropriate circumstances.

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Representing Injured Workers

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Attorneys designated as certified specialists have met standards of education and experience in their specialty which are set by the California Board of Legal Specialization of the State Bar of California.

The information contained in this Fensten and Gelber website is provided for informational purpose only and should not cause you to form an expectation about the results that you may achieve based on your potential legal claim. Because individual circumstances differ, you should not rely on any information here as being applicable to your given factual situation. You must not rely on any of the general information provided here as being specifically applicable to you.

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Making a false or fraudulent worker’s compensation claim is a felony subject to up to five years in prison or a fine of up to $50,000 or double the value of the fraud, whichever is greater, or by both imprisonment and fine.

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