Folsom Serious Injury Lawyers
If you’ve suffered a serious injury on the job in Folsom, California, you may be entitled to benefits under California Workers’ Compensation law. These benefits can cover medical care and partially replace lost wages. In some cases, you may also qualify for federal benefits.
Serious workplace injuries can make navigating Workers’ Compensation complex. Hiring an experienced attorney is critical to protecting your rights and ensuring you receive the benefits you deserve.
When Do You Qualify for Workers’ Compensation Benefits?
Under California law, you qualify for Workers’ Compensation if you are injured while performing job-related duties. Key steps include:
- Report your injury promptly. California requires that you notify your employer within 30 days of the injury.
- File a claim. Submit a Workers’ Compensation claim with your employer’s insurance provider. Include medical documentation supporting your injury.
- Prove job-relatedness. Your injury must be connected to your work duties.
Once approved, you may receive temporary benefits while recovering.
Temporary Benefits for Serious Work Injuries
If your injury prevents you from working, Workers’ Compensation can provide:
- Partial Wage Replacement: Typically two-thirds of your pre-injury wages, up to California’s statutory maximum.
- Medical Coverage: Reasonable and necessary treatment related to your injury.
Temporary benefits generally continue until you reach maximum medical improvement (MMI), which can last up to two years for temporary disability under California law.
Complicating Factors in Serious Injury Claims in Folsom, CA
Even seemingly straightforward claims can be complicated. Common challenges include:
- Disputes over medical necessity. Insurance companies may contest costly treatments.
- Pressure to return to work. Employers or insurers may push you back before full recovery.
- Extensive medical documentation. Serious injuries often require multiple evaluations and detailed evidence.
- Insurance scrutiny. Higher-value claims are closely examined for potential cost savings by insurers.
Understanding the Disability Rating System
Once you reach maximum medical improvement (MMI), a doctor evaluates your condition and assigns a disability rating, expressed as a percentage of functional impairment.
- Example: A traumatic brain injury preventing any work could result in a 100% disability rating.
- Partial injuries receive a corresponding percentage.
This rating helps calculate your permanent disability benefits, which supplement temporary wage replacement.
Disputes Over Injury Severity
Insurance companies may challenge the extent of your injury to reduce their liability. You have rights if you disagree:
- Request a Qualified Medical Examiner (QME) or Agreed Medical Examiner (AME) for an independent evaluation.
- If disagreements persist, you can file a Declaration of Readiness to Proceed (DRP) with the California Workers’ Compensation Appeals Board.
- Ultimately, an administrative law judge may determine the final disability rating after reviewing medical evidence.
Settling a Workers’ Compensation Claim
After reaching MMI, you may settle your claim. Settlement options include:
- Lump-Sum Settlement: Covers lost wages and medical care; you assume responsibility for future medical expenses.
- Structured Settlement: Covers lost wages upfront while leaving medical benefits open to pay for future treatment.
A Workers’ Compensation attorney can negotiate to maximize the value of your settlement and ensure your long-term needs are protected.
Social Security Disability Insurance (SSDI) for Work Injuries
You may also qualify for Social Security Disability Insurance (SSDI) if your injury prevents you from working. Important points:
- You can receive both Workers’ Compensation and SSDI, but combined payments cannot exceed 80% of your pre-injury wages.
- SSDI claims often face initial denials, but appeals can increase your chances of success.
Experienced attorneys can navigate both systems to help maximize your total benefits.
Filing a Personal Injury Lawsuit for a Work Injury
Typically, Workers’ Compensation is your exclusive remedy against your employer. Exceptions include:
- Intentional harm by your employer.
- Employer knew the injury was likely and ignored the risk.
Frequently Asked Questions (FAQs) – Folsom Serious Injury Lawyers
- What should I do immediately after a serious workplace injury in Folsom?
- Report the injury to your employer as soon as possible (within 30 days under California law).
- Seek medical attention, even if injuries seem minor.
- Document the incident, including photos, witness names, and any work conditions that contributed to the injury.
- Contact an experienced Workers’ Compensation attorney to protect your rights.
- How long do I have to file a Workers’ Compensation claim?
- You must notify your employer within 30 days of the injury.
- The statute of limitations for filing a Workers’ Compensation claim in California is generally one year from the date of the injury, but it’s best to file as early as possible.
- How much money can I receive from Workers’ Compensation?
- Temporary disability benefits usually cover two-thirds of your pre-injury wages, up to the state maximum.
- Permanent disability benefits depend on your disability rating after reaching maximum medical improvement (MMI).
- Medical treatment related to your injury is generally fully covered.
- Can I work while receiving Workers’ Compensation benefits?
- You can return to work if your doctor clears you, but you are not required to work before you have fully recovered.
- If you can perform light or modified duties, benefits may be adjusted.
- Can I receive both Workers’ Compensation and Social Security Disability (SSDI) benefits?
- Yes, but combined benefits cannot exceed 80% of your pre-injury wages.
- Settlements can be structured to maximize SSDI eligibility.
- What if my employer or the insurance company disputes my injury?
- Disputes are common in serious injury claims.
- You have the right to request a QME or AME.
- If disagreements persist, the California Workers’ Compensation Appeals Board may schedule a hearing.
Our Folsom Serious Injury Lawyers at Walters & Zinn, Attorneys at Law Are Here for You
