San Diego Workers’ Compensation FAQs

Injured Workers on Workers' Comp FAQs

Gerald Brody San Diego Workers' Compensation Law Firm Can Help

At the Law Office of Gerald D. Brody & Associates, we are committed to helping employees who have been injured at work receive the benefits they need to make a full recovery. If you have questions about your workers’ compensation claim we haven’t answered here, please call us at (619) 528-9800 to schedule a free consultation.

The aftermath of a workplace accident is a stressful time for many reasons. If you’ve suffered an injury or illness on the job, your mind is probably spinning with uncertainty and concerns about what happens next. At the Law Office of Gerald D. Brody & Associates, we often have injured workers who come to us with questions such as, “How will I pay my medical bills?” and “Who will provide for my family while I’m unable to work?”

The workers’ compensation system exists to protect injured workers and ease some of the financial worries that come with recovering from a job-related injury or illness. However, there are many complexities that can be difficult to understand without an attorney to guide you through the process. Here are a few of the most frequently asked questions we receive about workers’ compensation:

What do I need to do if I’m injured at work in San Diego?

There are two critical components to reporting your workplace injury: telling your employer within 30 days of the date you were injured, and officially filing a workers’ compensation claim. You can accomplish both of these tasks at once by filling out the DWC-1 claim form and turning it into your employer.

What types of benefits can I receive from workers’ compensation in San Diego?

There are two main benefits an employee can receive through workers’ compensation. The first is medical payments. Your benefits will cover all expenses related to diagnosing and treating your work-related injury or illness, including doctor visits, medications, surgeries, physical therapy, and any equipment required to help you adapt to your condition. Injured workers are also eligible to receive disability payments. These funds are designed to make up for missed wages while you’re unable to work. The amount you receive is roughly two-thirds of your normal wages.

How do I know if I qualify for workers’ compensation?

There are three main criteria that must be met to be able to receive benefits through workers’ compensation. First, you must be an employee of the company you work for. Contractors and consultants are not eligible for workers’ comp. Second, your injury must have happened at work or be directly related to your job duties.

Lastly, your employer must carry workers’ compensation insurance. California businesses are legally required to carry workers’ compensation insurance, but not all of them do. If you meet the above requirements and your employer doesn’t carry workers’ compensation insurance, an attorney can help you sue your employer for missed wages, medical expenses, and pain and suffering related to your injury.

Can You Get a Second Opinion From Another Doctor for Workers' Comp?

YES – you always have the right to change your primary treating physician within the employer’s medical provider network. As long as you have a need for medical treatment and you see a doctor within the employer’s MPN, you can select a new doctor. As an unrepresented injured worker, you can change after the employer controls your medical treatment for the first 30 days.

Once you become represented, however, your attorney can designate a new treater for you immediately. You shouldn’t want your employer to control your medical treatment any longer than they have to, as there is an obvious conflict of interest in that situation. If you have any issues with your treating physician and are thinking about seeing a new doctor, contact us so we can identify a better doctor for you to see.

Can I bring a Civil Lawsuit Against My Employer for My Work Injury?

San Diego Workers' Compensation Attorney

MAYBE – in a limited number of circumstances, your employer’s conduct may open them to civil liability for the injury you sustained at work. Generally, when you are hurt at work due to an accident, your exclusive remedy is a workers’ compensation claim. This is the result of the great trade-off between the employee and employer whereby the employee cannot sue the employer directly for an accident at work in exchange for the employer carrying a workers’ compensation insurance policy that will provide adequate benefits. I use the term ‘adequate’ loosely here as the current workers’ compensation system has been reformed so much that it arguably fails to provide enough benefits for a working individual to make ends meet while recovering from an injury. You could also have a third party lawsuit against someone who causes your injury if you get hurt at work the result of someone or something not associated with your employer. In any of these situations, it is best to speak with an attorney to discuss the actual mechanics of your injury to determine if there are additional lawsuits outside of workers’ compensation that may be filed.

Will Hiring an Attorney for My Workers’ Compensation Claim Affect My Employment?

NO – As an injured worker, you are in a protected class and cannot be discriminated against for filing a workers’ compensation claim under the Labor Code. If your employer threatens or otherwise takes action against you to retaliate for being hurt on the job they are in violation of the law and can be punished.

As a workers’ compensation attorney, we have very little involvement with your employer. Typically, we let them know we have been retained so any issues regarding your treatment and work status can go through their insurance provider. That way, you don’t have to deal with legal and medical terms you may not understand how to properly communicate these things to your boss. We proceed for all intents and purposes against the workers’ compensation insurance carrier to pursue the benefits you are entitled to. Our goal is to keep you at work. To that end, we will exhaust every benefit you are entitled to so that you may achieve a full recovery and get back on the job. The last thing we want to do is create a hostile situation between you and your employer and put your job in jeopardy.

Can I still receive workers' compensation benefits if the accident was my fault?

Workers’ compensation is a tradeoff: an employee relinquishes his or her rights to sue the employer for an injury or illness, and in exchange, he or she can receive benefits regardless of who was at fault for the accident. There are exceptions, such as if the injury was self-inflicted or if you were under the influence of drugs or alcohol at the time of the accident.

What happens if my workers' compensation claim is denied?

Your workers’ compensation claim could be denied for a number of reasons. Whether it’s because you didn’t inform your employer of your injury on time, or because your employer is denying responsibility for your injury, you have a right to request a hearing before the California Workers’ Compensation Appeals Board. You can file an appeal on your own, but it helps to have a workers’ compensation attorney by your side that can protect your best interests and ensure you get the benefits you deserve.

Cost of Workers’ Compensation Lawyer

How Much Does It Cost to Hire a Workers’ Compensation Lawyer?

When you get injured or sick on the job, the financial blow can feel overwhelming. On top of paying for your medical bills, you’ll still have to find a way to support your family while you’re out of work. Fortunately, the workers’ compensation system exists to protect hard-working employees like you. Not only will your benefits cover any doctor visits, hospitalizations and surgeries you need to recover, but you’ll also receive disability checks to make up for your lost income.

You’ve probably been told that hiring a lawyer to walk you through the workers’ compensation process can help you receive maximum benefits. But with money worries already on your mind, handing over additional cash for legal representation probably feels out of reach. If this sounds like you, we have good news. Hiring a workers’ compensation attorney to represent you throughout your case doesn’t have to cost a dime up front.

At the Law Office of Gerald D. Brody & Associates, we handle our clients’ workers’ compensation cases on a contingency fee basis. This means if you win your case, you’ll pay your attorney a small percentage of your benefits or settlement. If you lose, there are absolutely no legal fees. Regardless of the outcome, you will never be charged by the hour for our services. This arrangement makes it possible for all injured workers, even those with limited resources, to enlist the help of a workers compensation attorney.

Cost of hiring a workers’ compensation lawyer in San Diego

Every state has its own laws about how much a workers’ compensation attorney can charge. And, to make it fair for the injured worker, the Worker’s Compensation Appeals Board must approve all legal fees before an attorney collects any funds. In California, workers’ compensation attorneys can earn 10 percent, 12 percent, or 15 percent of a client’s benefits.

Only certain benefits are considered when calculating a lawyer’s fee. If you received a settlement or permanent disability benefits, your attorney will receive a percentage. Legal fees are not paid out of your medical costs or temporary disability benefits unless your lawyer helped you receive a lump sum payment for overdue temporary disability payments.

How does the Workers’ Compensation Appeals Board determine legal fees?

The amount the board will approve depends on the specifics of your workers’ compensation case. The judge will take into account the complexity of your case, how much time your lawyer spent on your case, and the value of the benefits your lawyer was able to secure for you. Simpler cases that are settled prior to a hearing warrant a lower percentage fee than cases that require a hearing or trial. Typically, lawyers only receive the maximum of 15 percent in very complicated cases. You won’t know the amount you’ll pay your workers’ compensation lawyer ahead of time, but we can give you an idea of the percentage we will seek at your initial consultation.

Extra costs related to your case

At the Law Office of Gerald D. Brody & Associates, there are zero up-front costs to have one of our workers’ compensation attorneys represent you in your case. When you win, there are no out-of-pocket expenses – your legal fees will be paid directly out of your settlement or benefits. However, there are sometimes extra costs related to your case that aren’t covered by the standard fee agreement. Common expenses that may come as an additional charge include:

  • Requests for medical records

  • Independent examinations by physicians

  • Costs of depositions

  • Attorney travel expenses

  • Copying costs

  • Costs of postage

  • Filing fees

We will provide you with an estimate of a typical bill for these expenses so you can know what to expect going into the workers’ compensation process.

Contact Gerald Brody & Associates Workers' Compensation Law Firm today

If you are having any problems with your work due to an injury, please contact an attorney in our office immediately by calling us at (619) 528-9800 to assess the situation.