Workers Comp in Anaheim

Before the arrival of Walt Disney, Anaheim operated as a wine center, teeming with vineyards and high-quality grapes. After a virus ravaged the vines in the 1880s, the city began producing citrus. The 1955 opening of Disneyland marked a shift in the Anaheim economy from agriculture to tourism. Drivers, cooks, valets, and musicians are just a handful of the occupations that fall under this sector and act as the backbone of the Anaheim economy.

Catering to 25 million visitors annually can take a toll on mental and physical health. That’s why workers compensation laws are in place; to ensure you get the care you need after a workplace injury.

According to the Bureau of Labor Statistics, employers reported 2.7 million non-fatal workplace injuries, highlighting the potential hazards workers face daily. According to the National Safety Council, the most common injuries that force people to miss work include:

1. Exposure to harmful substances or environments
2. Overexertion, bodily reaction
3. Falls, Slips, Trips

After an injury, the first step is to seek medical attention, then inform your supervisor that you’d like to file a workers compensation claim. Minor injuries that won’t keep you away from work are usually easy enough to file independently. However, when you’re seriously injured or your employer makes filing a claim an issue, it’s time to speak to an attorney with experience in workers compensation law.

Reasons to Hire an Anaheim Workers Comp Lawyer

A free consultation informs you of what to expect from your employer, physician, and insurance company throughout the workers compensation process. Most attorneys will let you know if the case is straightforward enough to handle on your own.

Workers filing claims often deal with the same recurring obstacles. This usually involves pushback from the employer, conflict with the insurance company, or questions regarding treatment.

Hiring a workers compensation attorney places an expert in your corner to tackle any issues that may interfere with your claim. Unfortunately, the process is more complicated than filling out a form and welcoming a check. You should consider the type of benefits you seek and whether you’re eligible for them. Medical, disability and vocational benefits are all options, but you need to know when, how, and what to ask for. This is where an attorney can clear things up, ensuring your path to timely compensation and treatment.

Here are more reasons to hire a workers compensation lawyer:

• Employer fails to report the claim to the insurance carrier.
• Employer tells you not to file a claim after an injury.
• Employer threatens to fire you for registering an injury.
• Employer denies the injury happened at work.
• You’ve been out of work for weeks with no word from employer or insurance carrier.
• Insurance carrier disputes the claim.
• Your injuries may permanently keep you from working.
• Insurance carrier would like to discuss a settlement offer.

What Does a Worker’s Comp Attorney in Anaheim Do?

A workers compensation attorney works to secure medical treatment and disability benefits for an injured worker. The California workers compensation system is notoriously complex. Your attorney is there to answer questions, conference with doctors, draft legal documents, depose experts, and maneuver the outcome in your favor.

An attorney can guide you through each step of the process, gather evidence to support your claim, and represent you against your employer’s insurance carrier. They can facilitate each stage from filing a claim to settlement negotiations and trial before a judge if it gets that far.

A workers comp attorney can also:

• Get a complete history of workers medical records.
• Use experience with doctors, insurance companies, and opposition lawyers to reach a fair outcome for the injured worker.
• Know the doctors involved. Some are insurance-oriented. Some lookout for the patient first. Do you know the doctors well enough to tell the difference?
• Get a complete understanding of the injury and how it impacts the employee’s ability to go back to work.
• Use experience with trial judges to know what expert witness to call.
• Cross-examine the insurance company’s witnesses.
• Handle all preparations and meet all deadlines if the case goes to trial.
• Know the grounds for appeal if the case gets that far.
• Conduct a pre-trial investigation (deposition), which involves taking the sworn testimony of witnesses, including the medical professional that treated you.

How Much Does a Workers Comp Lawyer in Anaheim Charge?

Workers compensation attorneys receive a percentage of your settlement after winning a case. A judge must approve this amount and can vary based on how much work the attorney puts in. In California, the amount is usually 12% to 15% of the settlement.

For example, under California workers compensation law, if an injured worker is awarded $100,000, their attorney fee will likely range from $12,000-$15,000.

However, you only pay your attorney if you secure a settlement. If your claim is denied, you won’t owe an attorney fee. You don’t need to worry about falling short on funds when searching for legal aid. Claimants filing with an attorney will likely receive larger settlements than those who navigate the process alone.

Attorneys may act judiciously when deciding whether to accept a case. They must be confident in the likelihood of a win; otherwise, they won’t get paid. This means most attorneys won’t waste your time if they don’t think they can be of some aid.

How to Handle a Workers Comp Case on Your Own in Anaheim, CA

Most claims do not require the help of a workers comp attorney. When the system works as intended, you simply have to notify your employer to kickstart the process of filing a workers compensation claim. If things do not work out in your favor, you have the option to appeal a claim denial. This will require the help of a workers comp lawyer, but for reference, the step-by-step guide is detailed below.

How to File a Workers Comp Claim in Anaheim

Employees injured on the job in Anaheim should notify a supervisor immediately to ensure receiving benefits, including medical care. If the injury or illness developed gradually, it should be reported to the employer as soon as you believe it was caused by your job.

To protect your rights, file a claim form as soon as possible. Your employer must give or mail you a claim form within one working day after learning of your injury or illness. The California claim form can be downloaded online. Workers also can contact the Department of Industrial Relations’ Information and Assistance Unit online or by calling 1-800-736-7401.

Once you have the claim form, fill out the “employee” section, sign and date it, and send it to your employer right away. Always keep a copy. The claim form should be returned to the employer in person or by mail. If you mail the claim form, use certified mail (“return receipt requested”) so there is a record of the date it was mailed and received.

Failure to return the completed form to your employer puts you at risk of losing your right to benefits. If your employer does not give you a claim form, contact an information and assistance officer.

Employers Responsibility in Anaheim Workers Comp Claims

Employers are responsible for completing the “employer” section of a claims form and forwarding the completed claim form to the insurance company. Employees should receive a copy of the completed claim form from their employer; if you don’t, request a copy and keep it for your records.

Deadlines for Anaheim Workers Comp Claims

There are multiple deadlines for all parties a Anaheim workers comp case and following them is essential to make sure your claim is processed efficiently.

The most important deadline for injured workers is reporting an injury or illness within 30 days of when you believe it incurred on the job. For most workplace maladies, determining when the injury occurred is simple enough, but repetitive-stress injuries or occupational diseases that occur gradually, can make that determination complicated.

For those cases, the timeline for reporting and filing your workers comp claim starts when the following happen:

• You first missed work or saw a doctor for the injury or illness
• You knew or should’ve known that it was caused by your work, generally because the doctor explained that to you.

Once your injury is reported and your completed claim form submitted to the insurance company, your employer must authorize medical treatment for you within one day, to a maximum of $10,000, while your claim is investigated. If that authorization is not provided, you should immediately contact California’s Information and Assistance Unit for help.

When the claim is submitted, the insurer has 14 days in which to mail you a letter with the status of your claim. Contact the insurer if you don’t receive a letter within 14 days.

If your employer does not deny your claim within 90 days, you can presume that your injury is covered. If the injury or illness forces you to miss work, you should begin receiving temporary disability benefits within 14 days after the insurer learns about the injury and your temporary disability. If the insurer doesn’t start the payments by then or respond to the claim by denying it or asking for more information, it will be required to pay a 10% late penalty on the disability payments.

How to Appeal a Claim Denial in Anaheim

If your workers comp claim is denied, you can file an appeal with the state Division of Workers Compensation Appeals Board using this form.  After completing the form, you must file it at the Anaheim DWC office. You must serve the appeal to all other parties.

Phone: (714) 414-1800

1065 N Link Suite 170
Anaheim CA 92806-2131

The DWC office will send you a notice confirming that it has been filed. The notice will include your assigned case number, which will begin with the letters “ADJ” followed by a sequence of numbers. Use the assigned case number on all documents and correspondence.

Next, you must file a Declaration of Readiness to Proceed to request a hearing before a workers compensation administrative law judge. Your case will be scheduled for a hearing called a mandatory settlement conference (MSC). At the hearing, workers will want an experienced workers comp attorney in their corner.

The judge will discuss the case with you and your claims administrator and try to assist the both of you in reaching a settlement. If your case is not settled at the MSC, you will need to prepare documents that outline the dispute, identify the items each party will present at trial and the names of the witnesses that each party will ask to testify.

The trial will be held before another judge, and you will be required to attend. The judge will issue a written decision after the trial and send it to you by mail, usually 30-90 days after the trial. If either you or the claims adjustor disagrees with the judge’s decision, a Petition for Reconsideration can be filed.

If there is a disagreement between you and your claims administrator over the diagnosis of your injury by your treating physician or treatment plan, you most likely will need to request a qualified medical examiner (QME) to review your case and issue a medical-legal opinion. These are doctors that meet additional educational and licensing requirements

If the worker is represented by an attorney, the attorney may try to convince the claims administrator to agree to a doctor to review the case, known as an agreed medical examiner (AME). This can be a quicker more efficient process than a QME.

What to Do If Your Employer Does Not Have Workers Comp Insurance

It is illegal for an employer to run a business in Anaheim without carrying workers compensation insurance. Those that fail to do so are subject to steep fines, having their business shut down, criminal charges, and even jail time for the employer.

If you believe your employer is not insured, contact your local Department of Industrial Relations Division of Labor Standards Enforcement (DLSE) office and make a complaint. Go to www.dir.ca.gov/dlse to find a local office.