The workers’ compensation system in California can be complicated and frustrating. The need to choose the right physician for your injury, file the necessary paperwork for your claim, and make sure you receive the medical and wage replacement benefits you are entitled to can be a lot to process.
Here are some tips most people who end up being injured on the job wish they would have known before their accidents to help ensure a successful workers’ compensation claim:
1. Predesignate A Treating Physician
Choosing a physician to treat you for your workers’ compensation case can be daunting. Often times, the Medical Provider Network provided to you by your employer’s workers’ compensation insurance company will not contain a single doctor that you recognize. In California, an employee can choose to treat with his or her own personal physician for his work injury if the employee has notified the employer in writing before the work injury occurs.
In order to predesignate a physician, you should contact your employer’s human resources department and ask for the predesignation form. Alternatively, the form can be found here: https://www.dir.ca.gov/dwc/FORMS/DWCForm_9783.pdf. After you have completed the form and your physician has signed it, you must submit the form to your employer so that they may have proper notice of your predesignation.
2. Report, Report, Report
Employees often hold off on telling their employers that they were hurt on the job, but reporting your injury immediately is crucial for a successful workers’ compensation claim. It’s ideal to report your injury immediately, but California workers have 30 days from the date of a work injury to inform their employer and file the proper forms.
Employers are often confused about the proper procedure for starting a claim on behalf of an injured worker. In that case, filing an incident/accident report or filing a description of the event in some way to document the accident is better than nothing, even if handwritten.
3. Treat, Treat, Treat
One of the main benefits the workers’ compensation system provides for injured workers is medical treatment for their work injury. In order to remove any doubt an insurance adjuster might have about the legitimacy of your injury, it is important to seek medical treatment immediately and properly notify your workers’ compensation doctor of every ailment you have suffered as a result of your work injury. It is also critical to make every appointment and follow your doctor’s orders exactly.
Once your employer has started your workers’ compensation claim, their insurance company is responsible for the first $10,000.00 in medical costs until the insurer either accepts or denies the claim. Thus, there is incentive to treat with a doctor even if you have to pay out of pocket to create a proper medical history of the event as the insurance company will have to reimburse up to the $10,000.00
4. Cooperate, Albeit Cautiously
Because there is so much communication between the injured worker, employer, and insurance carrier early on in a workers’ compensation claim, oftentimes injured workers also rely on their insurance carrier for answers and information. Unfortunately, the insurance company does not share your same objectives in the case and oftentimes provides information that is incorrect and harmful to a claim.
While it is best to err on the side of disclosing information such as the release of medical records and prior injury history, etc. which the insurance company is entitled to, it is strongly suggested to avoid any communications with a private investigator hired by the insurance company. These investigators tend to be aggressive and threatening to make false statements about an injured worker’s claim and like to push in-person meetings and recorded statements. Also, any time an insurance carrier requests you be seen for a medical evaluation for determination of the compensability of your claim, as opposed to treatment visits with a doctor, you should be suspicious of their motives.
5. Don’t Wait Too Long To Get Help
Timing is extremely important to a successful workers’ compensation claim. Making sure that your injury is reported right away and filing the appropriate paperwork before your claim is barred by the statute of limitations is crucial. Creating a record of medical treatment and being treated by doctors who write strong medical-legal reports is necessary to ensure that you receive maximum benefits and the best medical care available.
Put your trust in a workers’ compensation lawyer at the Law Offices of Gerald Brody & Associates.
The workers’ compensation system is complicated and complex. Navigating it without the help of an experienced workers’ compensation attorney can leave the door open for your employer and their insurance carrier to misinform you and deny you the benefits that you are entitled to. At the Law Offices of Gerald Brody & Associates, we have over 45 years of collective experience helping injured workers collect maximum benefits from their injuries. If you’ve been hurt on the job and are looking for an experienced team of workers’ compensation attorneys to handle your claim, give us a call to schedule a free consultation. Call us at (619) 528-9800.