I don’t want to sue my boss, so I don’t think filing an Application is the right move for me.
Answer: You’re not suing your employer directly in a workers’ compensation claim. In a typical civil claim where one party is bringing a lawsuit against another party, the actual lawsuit is started by filing a complaint with the court. This happens when one person has been wronged by someone else and suffers some sort of damages.
While it is true that when you get hurt at work you have been damaged, generally speaking, it’s the actual labor that causes the injury or the condition of an accident occurs at the workplace. So, absent very limited exceptions, filing a workers’ compensation claim is an injured worker’s only remedy.
When an Application is filed, you are not bringing a lawsuit against your boss. Instead, you are pursuing your rights under the workers’ compensation system against the employer’s insurance company. It is the law in CA that employers must carry workers’ compensation coverage and therefore they are immune from lawsuits that arise from a commonplace work injury. The responsible party becomes the insurance company and that is the entity that workers’ comp benefits are sought from.
So what does filing an Application with the WCAB accomplish?
Answer: Although workers’ compensation claims are technically civil claims, instead of filing a complaint an Application for Adjudication is filed with the workers’ compensation appeals board. The filing of an Application triggers the WCAB to issue a case number to the parties and allows matters to proceed before an administrative law judge for disputes that may arise.
I want to file an Application for Adjudication because this injury has destroyed my life and I want to be compensated for my pain and suffering.
Answer: While similar in many respects, an Application should not be confused with a civil complaint. A workers’ compensation claim has many limitations as far as what benefits may be recovered (medical treatment, lost wages, indemnity for permanent disability and future medical treatment). These benefits are limited with respect to how long benefits may be paid, what medical providers are available and what medical treatment meets established criteria to be authorized and caps on recoveries for impairment.
A civil lawsuit focuses on many general and pecuniary (money) damages that may be recovered and presented to a jury to decide (pain and suffering, loss of future earnings capacity, loss of enjoyment, disfigurement, etc.) Many times, these damages can be presented in an unlimited manner meaning attorneys present evidence as to what they value these damages for and a jury gets to decide what damages may be owed.
In a workers’ compensation claim, however, the administrative law judge has the full authority to decide contested issues. Unfortunately, providing compensation for general and pecuniary damages is not a power the workers’ comp judge is given and there is no recovery for pain and suffering in a workers’ compensation claim.
Gerald D. Brody & Associates are the Adjudication Application Experts
The attorneys at Gerald D. Brody & Associates have many years of experience handling workers’ compensation claims on behalf of injured workers and are familiar with the limitations inherent in the system. To discuss how our office may be able to maximize your recovery and allow you to obtain your full benefits, please contact us at your earliest opportunity for a free consultation. We don’t charge an attorney's fee unless there is a recovery for you. Give us a call at (619) 528-9800