Sonoma County, California is nestled above the San Francisco Bay Area between the Pacific coast to the west and the Mayacamas Mountains to the east. The area is home to over 400 wineries located throughout 18 different Sonoma County regions, and is famous for its world-class wine varieties.
Often, these grapes are pruned and picked by seasonal laborers, many of whom are non-native English speakers.
“A lot of our injured workers tend to be monolingual Spanish speakers,” said Laura Rosenthal, a Certified Specialist in Workers’ Compensation Law with the firm Meechan, Rosenthal & Karpilow, P.C.
A workers compensation claim can seem simple, but complications often arise that call for a professional who can make sense of the nuances of the case while the worker focuses on recovering.
“Most people going through a workers comp claim are injured and stressed while getting these piles of paper that they can’t make sense of,” Rosenthal said. “Having a workers comp attorney who’s experienced and good at their job means you’ve got an advocate who can make sense of all the paperwork, who’s going to file for hearings, who will fight to get you all the benefits you deserve so you can focus on getting better.”
Reasons to Hire a Sonoma County Workers Comp Attorney
Injured workers may feel hesitant to hire a workers comp lawyer for several reasons including cost or fear of retaliation by their employer. There are instances where you may not need a lawyer. If your employer and insurance company handle your case properly, paying for adequate treatment and benefits on time, you may be fine on your own.
And then there are times when either your employer, insurance provider, or doctor makes decisions that don’t seem to align with your well-being.
“In the first 30 days after your workers comp injury, you have to be treated by a doctor that your employer sends you to,” Rosenthal said. “Often, people come in and say, ‘well this doctor is telling me that I have to come back to work but I don’t feel like I’ve been treated, or I don’t feel like I can work at my full capacity yet.’”
Workers who fear retaliation may feel more obligated to rush back to work before recovering fully from their injury. “Often times what results, is they’ll come back to work again and then their injury gets worse,” Rosenthal said.
Other signs that your case may be better handled by a workers compensation attorney in Sonoma County include:
- You’re injured at work and your employer doesn’t report your injury to the insurance company or doesn’t provide you the form to report it.
- You are not getting paid any benefits/you are being denied medical treatment
- You were fired after reporting an injury
- You were released by the doctor but your employer will not provide accommodations for the work restrictions.
- You are not sure you’re getting all the benefits you should be receiving.
What Does a Workers Comp Lawyer in Sonoma County Do?
Workers compensation law isn’t a field you can master overnight. “It is a complex system, and it requires a lot of knowledge and education to learn,” Rosenthal said.
Often, workers find themselves in over their heads when trying to handle a case on their own, especially if there’s a third party involved. This can result in a lack of adequate medical treatment or a delay/downright refusal of benefits.
“Sometimes we have individuals who show up and they can’t find doctors who will treat them, or they’re getting medical bills related to their workers comp injuries and being asked to pay them,” Rosenthal said. “People come in and they have bags full of paperwork that they just don’t understand.”
From the onset, a workers comp attorney can interpret the system and weave through the insurance networks, ensuring your access to maximum benefits and recovery time.
“Most workers comp attorneys are trained negotiators aware of all the benefits that are available to workers,” “Rosenthal said. An injured worker is not typically aware of what they can negotiate for and often will end up leaving something on the table.
“Having a workers comp attorney — who is an experienced negotiator cognizant of all the benefits you can get — who also is an experienced negotiator — means you have the opportunity of getting everything that you’re entitled to, and perhaps a little more than you would ask for on your own.”
How Much Does a Workers Comp Attorney in Sonoma County Charge?
Worker’s compensation attorneys don’t get paid unless you do. They operate on a contingency basis, which means they’re paid a fraction of your settlement only after winning a case. Their compensation ranges between 9% and 15%.
“Workers Comp attorneys do not get paid directly by the client,” Rosenthal said. “When people come in and talk to us, the initial consultation is between half an hour to an hour, it’s still confidential and at no cost.”
Judges must approve all compensation for workers compensation attorneys, which adds another layer of protection for the worker.
“When we accept a case and take somebody on as a client, we do sign a fee agreement, but it specifies that it has to be authorized by a judge,” Rosenthal said. “There has to be an order signed approving our attorney fee.”
How to Handle a Workers Comp Case on Your Own in Sonoma County
Most claims do not require the help of a workers comp attorney. When the system works as intended, you simply notify your employer of the injury 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 Sonoma County
Employees injured on the job in Sonoma County 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 Sonoma County 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 Sonoma County Workers Comp Claims
There are multiple deadlines for all parties a Sonoma County 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 Sonoma County
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 nearest DWC office, such as the one in Santa Rosa. You must serve the appeal to all other parties.Phone: (707) 576-2391
50 D Street, Room 420
Santa Rosa, CA 95404-4771
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. “Given the complexity of how the law has changed in the last 30 years, they almost have to go out and get a lawyer now to assist them in getting over that denial,” said Robert McLaughlin, who has been practicing workers comp law in California for 30 years.
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).
“The panel QME process is very detrimental because it slows things down terribly,” he said.
What to Do If Your Employer Does Not Have Workers Comp Insurance
It is illegal for an employer to run a business in Sonoma County 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.
About The Author
Bill Fay has touched a lot of bases in his 45-year career. He started as a sports writer, gaining national attention for work on college and professional sports. He had regular roles as an analyst on radio and television and later became a speech writer for a government agency. His most recent work is as an internet content marketing specialist. Bill can be reached at email@example.com.
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