Types of Worker’s Compensation Cases

Types of Worker’s Compensation Cases

Worker’s compensation is a type of insurance that employers pay into so that they may support an employee who is injured or otherwise incapacitated on the job. Worker’s compensation is mutually beneficial to both employees and employers. Employees who are injured on the job receive financial support and in exchange, waive their right to file a lawsuit against their company.

judge gavel and money on brown wooden table
An accident of a man worker at the construction site.
An accident of a man worker at the construction site.

Injuries at Work:

In the state of California, a worker may only qualify for worker’s compensation if their injury was sustained during the regular course of business. For example, someone who is injured while doing their job would be eligible, but someone who was injured in a car accident in their workplace parking lot would not be eligible.

Let’s look at a hypothetical worker’s compensation situation. Carlos is a factory worker. One day, his machine malfunction and he badly injures his hand. The injury requires surgery and months of physical therapy before he regains full range of motion. Carlos needs his hands to operate the machinery at work, therefore, he is unable to work until he is fully recovered. In this instance, a worker’s compensation claim should cover Carlos’s expenses until he is able to return to his former post.

Temporary Disability Payments:

Employees who file a worker’s compensation claim will begin to receive temporary disability payments as paycheck replacement during their time away from work. Generally speaking, temporary disability payments are roughly 65% of the average weekly wage an employee was earning before they were injured.

There are two types of temporary disability payments: Temporary Total Disability (TTD) and Temporary Partial Disability (TPD). TTD payments are made when an employee is unable to work at all during recovery. TPD payments are made when an employee can work limited hours or perform limited duties due to their injury. The legal team at Guerra & Casillas can help you determine which you qualify for.

Smiling executives shaking hands at desk
Two young clinicians in blue uniform discussing online data in touchpad

Medical Treatment:

In order to maximize worker’s compensation claim, workers need to be thoughtful when it comes to seeking medical treatment. Seeking treatment right away is vital since it gives your employer’s insurance company less wiggle room to later claim that your injury did not actually occur in the workplace. Also, in California, you must seek treatment from the personal primary physician you designated when you began work with a company.

Employers are required to pay for your medical bills until a decision has been made on your worker’s compensation claim. If the claim is accepted, the employer must keep paying your medical bills.

Reimbursement for Self-Procured Medical Expenses:

If your employer fails to secure medical treatment for injured workers and the worker winds up seeking their own treatment, those medical expenses are considered self-procured. The employer is still responsible for reimbursing the injured party for reasonably priced treatments, so long as the employer is made aware.

Hospital and medical expenses
Insurance claim concept

Mileage to and From Your Medical Appointments:

Not only are employers responsible for medical treatment costs, but they are responsible for the cost of transportation too. This becomes particularly important if the injured worker requires specialized care that cannot be administered locally. Currently, injured workers are entitled to $0.535 cents per mile driven to and from medical appointments.

In order to receive reimbursement, employees must keep meticulous records of their travel, including relevant receipts, and then fill out the California Medical Mileage Expense Form.

Training & Rehabilitation If You Can No Longer Do the Same Work:

If a worker is injured permanently to the extent that they can no longer perform the job they were doing at the time of the injury, then worker’s compensation can be used for training, vocational rehabilitation, and schooling so that the injured employee may find a new profession.

For example, if Carlos from our previous hypothetical will never regain full control of his hand, he can consult a vocational rehabilitation counselor in order to find a new area of gainful employment that does not rely on dexterity.

If you are struggling to file a worker’s compensation claim or feel that your claim is being handled unfairly, then contact Guerra & Casillas right away for help and representation. We are here to help you get back on your feet and back to work!

Rehabilitation for old woman in wheelchair