Personal Injury - Workers Compensation Law

The Law offices of Paul Aghabala are now Located in Sherman Oaks California. Our new phone numbers are: (877)75-LA-LAW or (818)788-0808. We are dedicated and specialize in resolving Personal Injury - Workers Compensation Law cases for our clients in the greater Los Angeles area.

The workers' compensation system is a no-fault, exclusive remedy system. What this means is that employees are entitled to receive prompt, effective medical treatment for work-related injuries or illnesses no matter who is at fault and, in return, are prevented from suing their employers over those injuries.

BY LAW, California employers are required to have workers' compensation insurance, even if they have only one employee, and even if it’s only temporary. Certain professions require workers’ compensation insurance even if there are no “employees.” Check with your insurance carrier or attorney to be sure you comply with the law. Keep in mind that coverage for sole owners is optional.

Failure to have workers’ compensation coverage is a criminal offense punishable by either fine or imprisonment for up to one year, or both. Employees who are injured while working for an illegally uninsured employer may receive benefits from the Uninsured Employers’ Benefits Trust Fund (UEF) who will seek reimbursement from the responsible employer. Other penalties may be imposed on the illegally uninsured employer.

In addition, an employer must post a “Workers’ Compensation Poster” at the workplace in a location where all employees can see it. Failure to do so is punishable by a fine. A pamphlet explaining employee’s rights and responsibilities regarding workers’ compensation should also be provided to new employees.

If an employee gets hurt or sick because of work, the employer is required to pay workers' compensation benefits. Workers' comp insurance provides six basic benefits: medical care, temporary disability benefits, permanent disability benefits, supplemental job displacement benefits or vocational rehabilitation (pre-2004 injuries) and death benefits.

If an employee gets hurt or sick because of work, the employer is required to pay workers' compensation benefits. Workers' comp insurance provides six basic benefits: medical care, temporary disability benefits, permanent disability benefits, supplemental job displacement benefits or vocational rehabilitation (pre-2004 injuries) and death benefits.

Each party has its own responsibility in the event of an injury. The injured employee has a duty to report the injury right away after it occurs. In the case of a cumulative trauma, the injury must be reported as soon as the employee learns or believes that the injury was caused by work. Failure to report an injury promptly could affect benefits.

When an injured employee reports an injury, a claim form must be completed and sent to the workers’ compensation insurance carrier, with a copy provided to the injured worker. Treatment must be authorized within one day of filing the claim, even if the claim is not immediately accepted. Initial treatment is limited to $10,000 while the insurance company investigates the claim before accepting or denying it.

Generally, the insurance company may require the injured worker to see a doctor within their Medical Provider Network (MPN) which consists of a large selection of doctors with different specializations. There is a process whereby employees can pre-designate their personal doctor. This should be done with the employer before any injury occurs. Forms are available on the DWC website.

Treating doctors will issue medical reports and recommend treatment. If the injured worker disagrees with the doctor’s finding, there are different ways to handle the situation depending upon whether or not the injured worker is represented.

Injured employees who are unable to work according to their doctor may receive Temporary Disability Benefits (TD). The amount paid depends on one’s wages for the year prior to injury. As a rule, the worker will receive two-thirds of his/her average weekly wage; however, there is a minimum and maximum amount paid. TD is paid until the worker is released back to work by the treating doctor. However, TD is limited to 104 weeks, except in extreme and chronic cases. Once a worker has reached Maximum Medical Improvement (MMI), when further treatment will not improve the worker’s condition, the treating doctor issues a report indicating the worker’s Whole Person Impairment, if any. This percentage of disability is then inserted into a complex formula, including age, occupation and effect on future earning capacity to determine the amount of Permanent Disability (PD) benefits the worker should be paid.

Sometimes a worker has a pre-existing condition or injury that affects the current condition. Then a percentage assigned to that condition will be deducted from the doctor’s finding. This is known as apportionment.

The claim may be settled by Compromise and Release which will provide the worker with a lump sum amount to cover the PD and future medical care, if any. In the alternative, the claim may be settled by Stipulation with Request for Award (stip) which does not settle out future medical care. Generally with a stip, the amount of PD is paid out weekly until exhausted, but medical care remains open. Both settlements must be reviewed and signed by a Workers’ Compensation Administrative Law Judge.

A third way to settle a claim is by hearing, or trial, before a Workers’ Compensation Administrative Law Judge. After trial, the Judge will review all the testimony and evidence and issue a ruling in the form of a Findings & Award (F&A). The Judge will determine how much PD should be paid. The F&A is appealable.

Often times, a doctor will issue work restrictions in the final report. Some of these are minimal, but others may prevent the worker from returning to the pre-injury occupation. Sometimes, an injured worker can return to his/her usual occupation with some modifications. There are laws protecting the injured worker in his/her return to work that the employer and insurance company must abide by.

The Law offices of Paul Aghabala are centralized in Los Angeles County,Sherman Oaks and Woodland Hills. We can be found on the internet under "Los Angeles Personal Injuries Lawyer"," Sherman Oaks Personal Injury Lawyer ", and " Woodland Hills Personal Injury Lawyer".