Workers Comp in Sacramento

Sacramento has an illustrious history of industry, discovery, and innovation. The city has attracted workers as a destination of opportunity and wealth from its inception.

In 1839, John Sutter, a Swiss-born pioneer, established the colony of Nueva Helvetia or New Switzerland. Soon after, the sighting of gold in the surrounding valley would spark the California Gold Rush. Prospectors pillaged the lands, combing for golden ore, leaving Sutter destitute and bankrupt. He left the land to his son, who would create the layout for what was known as the city of Sacramento later that year.

Today, Sacramento is home to a diverse population of workers from different backgrounds, mainly specializing in agriculture, clean energy, and tech. Most of these workers are protected under California’s workers compensation laws, ensuring access to timely treatment and compensation after a workplace injury.

Reasons to Hire a Sacramento Workers Comp Attorney

In 2019, the total cost of workplace injuries was $171 billion, according to the National Safety Council. This comes as no surprise if one considers that every seven seconds, a worker is injured on the job. After sustaining a workplace injury, workers should inform their supervisor and begin filing a workers compensation claim. If you’re met with hostility from your employer or realize you may miss substantial time from work, you should call a workers compensation attorney for a free consultation.

Many workers fear getting fired for reporting an injury. Some worry their bosses might replace them while they’re recovering. This often leads to workers delaying their claims or choosing not to file altogether. Tell your boss about your injury immediately–no more than 30 days after it happened–otherwise, you risk losing the right to receive benefits. You have one year from the date of your accident to file a claim, but the longer you wait, the harder your case becomes to resolve.

Even if you find the courage to confront your boss, you may shun the workers comp process because it’s complicated and time-consuming. California workers compensation has undergone several reforms making it increasingly difficult to navigate for anyone without a solid grasp of its concepts and procedures. A workers compensation attorney ensures you receive the treatment you’re entitled to without delay. They can fill out all the paperwork correctly, so you don’t have to worry about your claim falling through the cracks. They can also take depositions, conduct discovery (investigations), and perform legal research to reinforce your case.

Here are some signs you should call a workers compensation attorney:

• Your injury is severe enough that you expect to miss more than two weeks
• Your employer says the injury didn’t happen at work
• The insurance company denies medical treatment ordered by a physician
• You had prior injuries to the same body part
• Your employer or insurance carrier delays your claim
• You suffer permanent disability, either partial or total, that will prevent you from ever fully returning to work
• Your employer retaliates against you because you filed a claim
• You are ready for a settlement

What Do Workers Comp Attorneys in Sacramento Do

Claim investigations can take up to 90 days before rewarding disability benefits. A workers comp attorney will do all they can to bolster your case by gathering evidence, drafting legal documents, and countering any attempts by your employer to discredit your claim.

When it’s time to negotiate a workers comp settlement, an attorney is essential for estimating the value of your claim. Without professional guidance, you risk settling for less than the maximum you’re entitled to. Workers comp attorneys know the schemes insurance carriers will pull to underpay or avoid paying altogether. They also know the policies to protect workers from such actions, putting them in the optimal position to negotiate on your behalf.

A good workers comp attorney will make all your options clear. They can assist in filing lawsuits against third parties that may have contributed to your injury. They can also advise you in pursuing other government, disability, or rehabilitation benefits you may qualify for.

Here are more things a workers comp attorney can do for you:

• Get a complete understanding of the injury and how it impacts an employee’s ability to go back to work
• Conference with doctors treating the injury
• Take depositions when necessary
• Conduct settlement negotiations with the insurance carrier
• Use experience with doctors, opposition attorneys, insurance carriers, and judges to reach a favorable outcome for the client
• Handle preparations and deadlines if the case goes to trial
• Prepare your side of the argument, giving you the best chance of a favorable outcome
• Cross-examine the insurance company’s witnesses
• Know the grounds for appeal if the case gets that far.

How Much Does a Workers Comp Lawyer in Sacramento Charge

A workers compensation lawyer is paid on a contingency basis. This means they only get paid when you’ve been awarded a settlement. If you don’t get paid, neither does your attorney.

If you win your case, a judge will decide the amount your attorney receives, which usually falls between 12% to 15% of the settlement amount.

For example, if you’re awarded $100.000, your attorney could receive $12,000 to $15,000. However, hiring a lawyer will likely lead to a higher settlement even when accounting for their fee. Workers comp attorneys know how to develop a case by using various tools to fortify your claim and gain the maximum attainable compensation. In short, if you negotiate alone, you may lose sight of all the benefits available to you.

A workers comp attorney will factor in the severity of your injuries and limitations, past and future medical expenses, wage loss benefits, and the extent of your disabilities. They will clear up the factors that support your claim, so you risk leaving nothing on the table.

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

Employees injured on the job in Sacramento 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 Sacramento 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 Sacramento Workers Comp Claims

There are multiple deadlines for all parties a Sacramento 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 Sacramento

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 Sacramento DWC office. You must serve the appeal to all other parties.

Phone: (916) 928-3101

160 Promenade Circle, Suite 300
Sacramento, CA 95834-2962

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 Sacramento 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.