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How to maximize my workers’ compensation settlement in California?

How to maximize my workers' compensation settlement in California

Work injuries can result in expensive medical bills, lost work time, and stress about paying for living expenses. In case of injury, workers have a legal right to certain benefits provided by employers through workers’ compensation policies. Although workers’ compensation claims can be complex, there are some things you can do to improve the outcome. In this overview, you will find tips to help maximize your compensation from your workers’ compensation settlement.

Eligibility and Qualifying Injury

Workers’ compensation insurance is mandatory in California. Workers’ compensation is available to most employees. Whether your injury qualifies is another matter. Determining whether an injury was work-related is relatively straightforward in most cases. Work-related injuries occur when you perform tasks or assignments for your employer or their benefit. Stress Related Injuries (SRIs) may also qualify for workers’ compensation, such as carpal tunnel stemming from repetitive actions and consequential stress while performing tasks at work. California Labor Code Section 3600 further outlines the compensation conditions for workers in California. If you are unsure whether your occupational injury, illness, or SRI qualifies for workers’ compensation or have received a denial, do not hesitate to contact a California workers’ compensation attorney for help and knowledgeable advice.

Seek Medical Attention Right Away

After a work-related injury getting medical attention immediately benefits your recovery options and strengthens your workers’ compensation claim. It may seem sensible to wait out an injury in hopes that it heals on its own. However, a visit to a healthcare provider is the first step towards official documentation of the injury. Further, insurers may claim that if you don’t seek medical help right away, the injury may not have occurred at work, wasn’t related to your job, or was minor. Delaying medical attention and diagnosis may result in the denial of your claim.

Discussing Your Injury with a Physician

When speaking with your physician or healthcare provider, be sincere and specify your concerns. For example, describe how the injury occurred, how it affects you, and how it impacts your day-to-day activities compared to before. Being forthcoming and descriptive with your physician is vital as the information you provide them with assists with your treatment and in determining how the insurance company views your injury and proceeds with your settlement.

Documentation and Deadlines

Documentation is a critical component of a workers’ compensation settlement. The more documentation collected and presented, the stronger your case. It is essential to keep a record of details you recall about the incident that led to your injury, including a description of the injury itself, as you will have to provide information regarding it to your employer on specific forms and throughout the workers’ compensation process. A settlement amount can be calculated more effectively and efficiently the more information you provide about the injury and its medical documentation.

California workers’ compensation also requires the submission of documents and compliance with specific timelines. For example, you may be denied if you do not inform your employer of the injury within 30 days. Along with documenting your injury from a medical standpoint, submit documents and report your injury within the correct timeframe as outlined in the California Labor Codes. After reporting your injury, your employer must provide you with a workers’ compensation claim form. Complete the form promptly and accurately.

In California, you have one year to file a workers’ compensation claim from when the injury occurred. The wisest option is to report and file as soon as possible. Keep all documents organized to maximize the chances of a positive outcome and a favorable settlement.

Tip: Make copies of all relevant forms and correspondence, keep track of all medical paperwork, and ensure you meet all required deadlines.

Speaking with Insurance Representatives

The insurance companies are not on your side and may even hire a private investigator to probe you and your injury’s credibility, searching for contradictions and irregularities to find a reason for denial or lowering your settlement. However, there are limitations to their investigative measures. Essentially, they are permitted to follow you and take photos and videos of you in public. They may not hack your email, tap your phones, or enter your home. In addition, social media posts that are accessible to them may be used to monitor you, including any check-ins to places you are going or have been. The investigator may also attempt to interview your loved ones, family, and even neighbors. It’s best to be careful about what you post on your socials, ask your family and friends to decline to speak with investigators and be cautious in public spaces. However, so long as you are truthful, you shouldn’t have to worry but stay mindful.

Commonly, these tactics are reserved for cases in which the settlement has the potential to be a considerable amount. However, the insurance company frequently asks for written statements to keep on record regarding the details of an injury. However, you are entitled to refuse, and it is usually advisable to say no. After all, the insurer is working to protect their client, the company, and their assets. The insurance representative (or adjuster) may seem friendly, but they are not looking out for your best interests. In addition, the insurance company will likely send you plenty of paperwork. You should not blindly sign every form sent your way. Alternatively, you should review all paperwork carefully and have your attorney do the same. Ensure you are not granting unwarranted access to your case or signing away your rights.

When to Hire a California Workers’ Compensation Lawyer

Hiring a workers’ compensation attorney has many benefits. In some cases, employers don’t report workplace injuries to insurance companies. Employers may be distracted or forgetful at first. However, others may deliberately delay or avoid a workers’ compensation claim to avoid increasing their insurance premiums. A lawyer may also be helpful if you haven’t received all the benefits you’re entitled to, if your employer doesn’t pay, or if communication between you and your employer or the company’s doctor is poor.

When considering a settlement, a skilled workers’ compensation attorney can help determine, establish, convey, and negotiate how much compensation your injury necessitates. The length of the recovery process is one factor to consider before accepting a settlement. In terms of “Compromise and Release” settlements, you cannot reopen your case if your condition worsens or your prognosis changes. If you or a loved one have suffered a work-related injury, have questions regarding workers’ compensation, or are considering a settlement, consult an experienced California Workers’ Compensation Attorney.

Speak to an Experienced Workers’ Compensation Law Firm Today

If you seek to file a workers’ compensation claim or have already begun the process and received a denied or delayed claim, it is important to seek legal counsel as soon as possible.

With over three decades of dedicated experience, the attorneys at Castillo & Associates, have the skills necessary to handle the complex legal and insurance challenges typically associated with workers’ compensation claims in California. With a proficient legal team on your side, you will be able to focus on making a full recovery. If you are an injured worker, consider contacting the firm today for more information on your rights and legal options.

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© 2020 - 2023 Castillo & Associates. All rights reserved. The information contained in this Website is provided for informational purposes only, and should not be construed as legal advice on any subject matter or case. The content of this Website may not reflect current legal developments, verdicts or settlements. Castillo & Associates expressly disclaims any and all liability in respect to actions taken or not taken based on any or all the contents of this Website. This Website can be considered Attorney Advertising. Your use of this website does not imply nor create an attorney-client relationship. Any results or information presented does not imply a guarantee, prediction or promise regarding the outcome of your case.


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