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Work injuries can lead to significant setbacks. Not only can an injury lead to significant physical and emotional pain and suffering, but it can also severely impact a person’s income. At DiMarco | Araujo | Montevideo, our team is here to help if you need an experienced San Bernardino workers’ compensation lawyer by your side. We understand the challenges individuals face when they try to recover compensation for medical bills and lost wages in a timely manner. We will push back against aggressive insurance carriers and employers to make sure that our clients recover full compensation benefits for their losses. Contact our attorneys today at (909) 436-4610 to schedule your free consultation.
Ensuring that you recover full and fair compensation after sustaining a work injury or illness is challenging, particularly for those who do not have experience standing up to insurance carriers and employers. The other side has the money necessary to fight a claim, and work injury victims need an advocate by their side who can match those resources.
A San Bernardino workers’ compensation attorney will understand all of the changing work injury laws, know the applicable codes, and understand how to handle insurance companies in these situations. An attorney will make sure that their client is examined by a trusted medical professional as well as economic and financial experts who can help properly calculate total expected losses.
Finally, a workers’ comp attorney will handle the entire appeals process if it becomes necessary to ensure that clients are properly cared for throughout the entire process.
Almost every employer in the state of California is required to carry workers’ compensation insurance on their employees. The workers’ compensation system is designed to provide injured workers payment for their medical expenses as well as a significant portion of their lost wages if they cannot work while they recover from their injuries.
The workers’ compensation system in San Bernardino is considered a “no-fault” system. This means that an injured worker will be eligible for workers’ compensation benefits regardless of who caused the on-the-job injury. A worker can receive compensation even if they were responsible for causing their own injury in the workplace.
However, work injury victims are typically not able to file civil personal injury lawsuits against their employer or coworker for these claims. These types of civil claims are prevented by workers’ compensation insurance laws in most circumstances.
The workers’ compensation laws in California require that any individual who sustains an on-the-job injury report the incident to their employer within 30 days from the onset of an injury or illness. The injured worker must also fill out an official workers’ compensation insurance claim, specifically the employee’s portion of the form. This will typically be provided by the employer after they receive notification of the injury.
There are various regulations in place that determine when the 30-day reporting period actually begins. If a work injury or illness developed over a longer period of time (for repetitive stress injuries or occupational illnesses), determining the exact injury or illness onset date can be challenging. Typically, the 30-day reporting requirement begins when a person sustains an obvious injury or when they receive a diagnosis of an injury or illness they were previously unaware of.
Beyond the obligation to report injuries to an employer within 30 days, work injury victims in this state have a one-year statute of limitations in place. This means the worker has one year from the date of the accident or diagnosis of an injury or illness to file a workers’ compensation claim.
If your San Bernardino workers’ compensation insurance claim is denied, you have to begin the appeals process as soon as possible. Please understand the importance of working with a workers’ compensation attorney who can handle this complex appeals process on your behalf.
The first step in the process is filing an Application for Adjudication of Claim. This is part of the official workers’ compensation claim and gaining a case number.
After your initial claim has been denied, you need to request a hearing in front of the Workers’ Compensation Appeals Board (WCAB). In order to request this hearing, you or your attorney will have to fill out a form called a Declaration of Readiness to Proceed (DOR). From this point forward, there are various things that could happen:
In some situations, a WCAB judge could set a priority conference so a claim can be resolved quickly as possible. This will occur if the claim was denied because the employer or the insurance carrier did not believe that the injury arose out of employment (AOE) or the injury did not occur within the course of employment (COE).
If the employer or insurance carrier denies the claim for a reason not based on AOE or COE, then the pre-trial conference will be set for the claim. To give an example of when a pre-trial conference would be appropriate as opposed to a priority conference, this can occur if the insurance carrier does not believe that the medical treatment the person requests is appropriate or that an individual is not entitled to temporary disability benefits for their work injury or illness (among other reasons).
The work injury victim and their workers’ comp attorney will receive notice of the hearing time, date, and location. During a pre-trial conference, the workers’ compensation judge will attempt to resolve the issue between the two parties. If the issues cannot be resolved at a pretrial conference, the judge will set up a date for a future trial and establish a discovery plan for both sides to follow to produce the evidence they believe supports their case.
As we mentioned above, nearly every employer in the state of California has to carry workers’ compensation insurance for their employees. This essentially takes liability for most work injury incidents away from the employer, meaning the employee cannot file a lawsuit directly against the employer or another employee for their injuries. Since this is a “no-fault” system, determining liability in the traditional sense of a personal injury claim is not necessary, though there may still be an investigation into the incident.
There are some situations where a person could file a third-party personal injury lawsuit against an allegedly negligent party. In these situations, there are other individuals or entities responsible for causing a person’s workplace injury. In the event an injury is caused by someone other than the employer or a coworker, the injury victim may be able to file a personal injury lawsuit in civil court to recover compensation for their losses.
Some of the most common examples of third-party claims arise in situations where:
When a third-party claim is appropriate, this will allow the injury victim to perhaps recover additional types of compensation if their claim is successful. This includes full coverage of medical bills, lost wages, and even pain and suffering losses, which are typically not available under a workers’ compensation insurance claim.
There are specific types of workers’ compensation benefits available through the workers’ compensation system in San Bernardino. This includes the following:
The total amount of compensation an injured worker receives will vary depending on the circumstances surrounding each particular work injury situation, including whether or not you are in a labor union. Most of these claims revolve heavily around the severity of the injury. For example, a person who sustains a severely broken bone will likely receive more compensation than a person who sprains their wrist and only misses a few hours of work. However, any type of work injury should be reported. No individual should have to pay out-of-pocket for any medical bills caused by a workplace injury.
|Private Industry||Total Recordable Records Per 100 Full-Time Workers|
|Agriculture, forestry, fishing and hunting||4.6|
|Transportation and warehousing||4.6|
|Health care and social assistance||4.3|
|Arts, entertainment, and recreation||3.7|
|Accommodation and food services||2.7|
|Real estate and rental and leasing||2|
|Administrative, support, waste management, and remediation services||1.9|
|Other services (except public administration)||1.6|
|Mining, quarrying, and oil and gas extraction||1.3|
|Professional, scientific, and technical services||0.9|
|Management of companies and enterprises||0.6|
|Finance and insurance||0.4|
There are countless types of work injuries that can occur in and around the San Bernardino area. This includes just about any type of physical injury that can occur in the workplace, including the following:
In addition to these acute traumatic injuries that are often immediately apparent, the workers’ compensation system in California will also cover other types of injuries that are not as easily noticeable. Many injuries do not occur as a result of a single traumatic incident. In some cases, repetitive motion and overuse injuries, like carpal tunnel syndrome and tendonitis, occur after a person has been performing the same emotions on the job for months or even years. Repetitive motion injuries can affect the back, hands, wrists, joints, shoulders, forearms, knees, and more.
The workers’ compensation system will also cover various types of medical conditions that can arise as a result of the workplace, particularly if there is a strong link between the illness and disease and workplace exposure. Some of the main types of occupational illnesses that can occur include:
When we examine data available from the Bureau of Labor Statistics (BLS), we can see that there were approximately 2.8 million non-fatal injuries or illnesses reported across this country last year (2021), which is nearly identical numbers from the year before.
Below are some of the questions we are commonly asked about workers’ compensation claims.
To determine if you are eligible for workers’ compensation benefits in San Bernardino, California, you need to consider the following factors:
To file a workers’ compensation claim in California, follow these steps:
It’s essential to act promptly and follow the correct procedures when filing a workers’ compensation claim in California. Seeking guidance from an experienced workers’ compensation attorney can also help ensure that you receive the benefits you are entitled to under California law.
After filing a California workers’ compensation claim, you will be notified about the status of your claim by the insurance company or the claims administrator. Here’s what you can expect regarding the approval or denial of your claim:
Keep in mind that the timeline for claim decisions may vary depending on the complexity of your case and the specific circumstances of your injury or illness. It’s essential to maintain open communication with the claims administrator, healthcare providers, and your attorney to stay informed about the progress of your claim and any next steps.
If you or somebody you love has sustained a workplace injury in San Bernardino and is having trouble recovering your rightful compensation, you need to work with an attorney as soon as possible. At DiMarco | Araujo | Montevideo, our team of work accident attorneys in San Bernardino has extensive experience handling complex work injury claims throughout California. We understand the workers’ compensation laws in this state, and we have the resources necessary to stand up to aggressive insurance carriers and employers to make sure you are properly cared for.
“Anthony Modarelli is an outstanding attorney. He always returned our calls in a timely manner. He always made sure we understood the process of our claim. He always made time during our appointments and [we] never felt rushed. I am so glad we found him and we were pleased with our settlement. Highly recommend him and his firm.”