Explaining a Workers’ Compensation Claim from A to Z

Worker's Compensation

Work related injuries can leave you stressed out and confused as to what steps to take next. While you may not be able to perform your regular job duties, you may feel pressured to do so because you still have to pay your bills, support your family, and take care of your household. 

Employees who get injured on the job have certain legal rights under the law. As an injured worker, you need to immediately consult with an experienced Orange County workers’ compensation attorney to protect your legal rights and ensure that you get the full compensation you deserve. Although an attorney can best explain what a worker’s compensation claim is, how it works, and what rights you are entitled to under the law, below is an overview that will provide you with a guideline.

How Does Workers’ Compensation Work? 

Workers’ compensation insurance provides employees benefits if they have a work-related injury or illness. Also known as workers’ comp or workman’s comp insurance, this coverage can help cover your medical costs and expenses. It can help replace wages from lost work time.

When you properly file a workers’ compensation claim and once the claim is accepted, you are entitled to compensation, regardless of who is at fault for the injuries or illness. The exact benefits you ultimately receive, however, depend on the nature of your injury, state requirements, and the specific policy your employer has purchased.

Not All Injuries Are Covered by Workers’ Compensation Insurance

Workers’ compensation insurance covers injuries you suffer during the scope of employment. There are certain incidences where workers’ compensation won’t provide coverage. Below are examples of the most common types of injuries that are covered:

  • Carpal tunnel
  • Back injuries from repetitive movement
  • Injury to the lungs for breathing toxic substances
  • Slip and falls at work
  • Injuries sustained in a car accident while driving for business

Below are examples of incidents and types of injuries not covered by workers’ compensation insurance: 

  • Benefits can be denied if blood/alcohol tests reveal the employee was under the influence of a controlled substance at the time of the injury
  • Self-inflicted injuries
  • The employee was in violation of the law or company policy
  • The employee was not on the job at the time of the injury

Workers Compensation Benefits

Depending on the specific facts of your work-related injury claim, you may be entitled to different types of compensation. Below is the breakdown of benefits to which injured workers are entitled under California’s workers compensation program:

  • Total costs of medical care and treatment related to the injury
  • Temporary disability benefits
  • Permanent disability benefits
  • Supplemental job displacement benefits
  • Death benefits

Who Is Considered a Covered Employee?

In California, most workers are covered by workers’ compensation. Worker’s compensation insurance covers different types of employees, including full-time, part-time and seasonal employees. Even if the employer has one employee, they are required by law to have workers’ compensation insurance. Moreover, immigration status does not impact an injured worker’s rights to medical and temporary wage replacement benefits in California.

Although California has some of the most comprehensive workers’ compensation coverage, it does exclude certain types of employees from receiving compensation. Some of these include:

  • Business owners/sole proprietors (aside from roofers)
  • Independent contractors
  • Domestic workers who are related to their employers
  • Individuals who work for aid (food, housing, etc.) rather than pay
  • Certain volunteers, including volunteers for non-profit organizations
  • Deputy sheriffs and deputy clerks
  • Students participating in amateur sporting events/amateur sports officials

Our Team Is Here For You 

Dana AoudiWhen you have suffered a work-related injury, your recovery and healing are the only things you should have to focus on. Leave the rest on us. 

We take great pride in helping you navigate through this difficult time, and in ensuring you receive the care, treatment, and benefits you are entitled to under the law.

If you or a loved one has been injured on-the-job or have developed a serious health condition that may be related to work conditions, you need to immediately hire an experienced Orange County workers compensation attorney to protect your legal rights and help you get the full benefits to which you are entitled. 

Take the first step in protecting your rights by calling the legal team at Aoudi Law for a free consultation. Contact us online or call us at 714-386-9874. 

For your convenience, you can now also text us at 714-386-9874, and we will get back to you within 24 hours of your inquiry.

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