Workplace Accident

In a food-production facility, a technician is burned after falling into a vat of hot oil.  A surveyor driving a company truck to a job site is injured when the brakes fail.  These workers were both injured by workplace accidents.  Can they obtain compensation for their medical expenses and wages lost from missing work?

Workers’ Compensation Benefits

California and other states have workers’ compensation laws (or “workers’ comp,” for short) restricting the legal action you can take against your employer for injuries from workplace accidents, but providing you with assured compensation benefits, like medical expenses, money to replace lost wages, among others.  Workers’ comp will also pay funeral benefits and benefits to the surviving spouse or minor children of employees killed at work.

When is Workers’ Compensation Not Your Only Remedy?

You may be able to sue your employer in court, if an agent of the employer acted willfully orrecklessly to injure you, or if the employer is liable for your injuries in a dual capacity.

  • An example would be an employee injured in an explosion while delivering flammable gas in a tank that was also manufactured defectively by his employer.  Workers’ comp will not protect the company from suit in its capacity as the manufacturer of the tank.  If the company knew of the defect, it may also have acted willfully or recklessly.

Can All Employees get Workers’ Compensation?

Your employer is required by law to purchase workers’ compensation insurance to cover on-the-job injuries.  Some states exempt smaller employers from this obligation, but in California, an employer with even one employee must carry workers’ compensation insurance, or face criminal penalties, including hefty fines and possible jail time.

What to Do if You’re Injured While Working

If you receive an injury in the course and scope of your employment, you should seek immediate medical attention and then report the injury to your employer as soon as it is practical.  Your employer will provide you with forms to apply for compensation benefits.

After you’ve filed the initial forms reporting the injury, you deal directly with a claims administrator, who works for the insurance company that will pay your benefits.  Most claims are paid promptly, without dispute, but the insurance company sometimes denies coverage or disputes the benefit amounts owed to certain employees.  This most often happens to people who have received the most serious injuries or who have been permanently disabled – the people who most need to receive coverage.

What Can You Do if Your Claim is Denied?

If your workers’ comp claims administrator denies part or all of your workers’ compensation claim, you have the right to appeal the decision to an administrative judge for the Workers’ Compensation Appeals Board.  You have a limited period of time to file the appeal after your denial of benefits

  • Although this hearing is called an appeal and is held at a local office of the Division of Workers’ Compensation, it is a trial, and it is your one chance to present the available evidence that best supports your case. 

Most laypeople simply don’t have the resources or the knowledge to present their appeal case in the best possible light, particularly if you are limited by your workplace injury.  Consult with an experienced personal injury attorney who handles workplace injuries law as soon as possible, to learn your rights and protect yourself.

A seasoned attorney familiar with workplace accidents law will file your claim properly and can build a proper casefile of evidence on your behalf, including medical bills, records and expert medical testimony necessary to establish the validity of your employment-related injury.

  • You may also have the right to sue the insurance company itself, if it has intentionally engaged in outrageous and extreme conduct outside the needs of normal investigation or defense of claims.

Take the time to schedule a consultation with a workplace injuries attorney.  Your attorney can advise you on your rights and your possible courses of action and help you pursue the solutions most likely to get you the maximum amount of compensation available, money that will help you and your loved ones to live a more normal life after your injury.


October 5, 2015