How is a Workers' Compensation case resolved?

Workers' Compensation claims are decided by a workers Compensation Appeals Board (WCAB) judge. The judge's decision, called a Findings and Award, may provide for future medical care, and may be reopened within five years of the date of the injury. If both sides agree on all the issues, they may sign a stipulated request for an award. The judge may base the award on this request.

In other cases, both sides to a disputed claim may decide to agree on a lump sum payment to settle the case. This is called a Compromise and Release, and must be approved by the WCAB judge. Once approved, the employer is released from all responsibility for future medical care, as well as other benefits.

Are the recent changes to the Worker's Compensation laws retroactive?

The courts have decided the majority of the provisions of the reform act are retroactive and apply to cases that pre-date the bill. This specifically applies to future medical awards before 2004. The new medical care procedures such as, managed provider network (MPN) and utilization review (UR) applies to all cases. Many of the other provisions that are retroactive are still being litigated.

Can a case be reopened?

If the condition has worsened, you may petition to reopen a case within five years from the date of injury after previously being awarded Workers' Compensation benefits by Findings and Award.

Even if you never took legal action, you may be able to file for benefits by filing a Petition to Reopen. If you believe you may be entitled to additional benefits. See a lawyer before the end of five years from the date of the injury.

What is the Statute of Limitations?

If you are injured at work, you must file for workers' Compensation within the Statue of Limitations, which are strict time limits set by law. Although there are many exceptions, the Statute of Limitations generally is one year from the date of injury. If you delay, or fail to report a work-related injury or illness, no matter what kind or how severe, your benefits may be delayed or denied. Because changes in the law have become effective different times, there may be different time limits depending on the date of injury.

During your case, you will receive notices from your employer. You must respond to these notices before the deadline, or benefits may be severely affected. There are many exceptions to the Statues of Limitations in Workers' Compensation. If in doubt, consult an attorney.

Am I entitled to other benefits?

If you have an injury or illness serious enough to prevent you from returning to work, you may be eligible for Social Security disability if you have been off work for 5 months or more. To qualify, you must have paid into the Social Security system in 20 of the last 40 quarters and are likely to be off work one full year or longer. If you feel this applies to you, contact an our office for more information.

Public employees who have retirement programs other than Social Security, may be eligible for disability benefits under the Public Employee retirement System (PERS), State Teachers' Retirement System (STRS) or county, city or other retirement systems. Under certain situations you may also be eligible for State Disability Insurance, Unemployment Insurance, Long Term Disability etc.

How does Workers' Compensation relate to my right under the ADA?

If you believe you have suffered discrimination due to a physical or metal disability, you may have a legal action under the Civil Rights Act, the Americans with Disabilities Act (ADA) or Fair Employment and Housing Act (FEHA) in addition to Workers' Compensation benefits. If you are a member of a Union, you may also have rights under your collective bargaining agreement between your Employer and your Union.

When does a job-related injury include a third party case?

For cases involving injury or illness caused by a third party—someone other than your employer—you have the right to file a civil lawsuit against the other party who caused the injury in addition to a workers compensation case. For instance, if an unsafe product or unsafe premises contributed to you injury, or if you suffer a violation of your civil rights such as discrimination, you may be entitled to additional compensation.

How will I pay the firm?

All attorney's fees in Workers' Compensation are decided by the WCAB, and are paid out of the settlement or award. If there is no recovery, you pay no fee.