Workers' Compensation FAQs

• Do I need to get an attorney immediately?

  The workers' compensation system is complicated and has many pitfalls for those who are not very familiar with it. Anyone who has anything other than a minor injury at work should consult an attorney to understand his/her rights and what needs to be done in order to secure those rights. Scheduling a free consultation to discuss Workers' Compensation benefits is recommended.

• Am I entitled to Workers' Compensation benefits?

  If you are injured or become ill, either physically or mentally, because of your job (including injuries resulting from a workplace crime), you may be entitled to workers' compensation benefits.

• What benefits am I entitled to?

  Workers' Compensation insurance provides five basic benefits:

  • Medical Care: Paid for by your employer to help you recover from an injury or illness caused by work
  • Temporary Disability (TD) benefits: Payments if you lose wages because your injury prevents you from doing your usual job while recovering
  • Permanent Disability (PD) benefits: Payments if you don't recover completely
  • Supplemental Job Displacement (SJDB) benefits: (if your date of injury is in 2004 or later) - Vouchers to help pay for retraining or skill enhancement if you don't recover completely and don't return to work for your employer
  • Death benefits: Payments to spouse, children, or other dependents if a worker dies from a job injury or illness

• How long will it take to resolve my claim?

  Each claim is unique, so it really depends on the circumstances surrounding your case. Schedule an appointment so that we can go over the process and steps needed to address your particular situation.

• What should I do if I am injured at work?

  Make sure your supervisor is notified of your injury as soon as possible. If your injury or illness developed gradually, report it as soon as you learn, or believe, it was caused by your job. Reporting promptly helps avoid problems and delays in receiving benefits, including medical care. If you don't report your injury within 30 days, you could lose your right to receive Workers' Compensation benefits.

• How do I fill out the claim form?

  You employer is required to give you a Workers' Compensation Claim Form DWC-1 to complete when notified of your injury. Alternatively, you can come by our office at 750 Bridge Street, Yuba City, CA and pick one up. The DWC-1 has detailed instructions. Complying with the notification requirements of the DWC-1 protects you if there is any dispute later as to whether you reported the injury.
  
  Complete only the "employee" section of the form and send it to your employer right away. Be sure to sign and date the claim form and keep a copy for your records. Return the claim form to your employer in person or by mail. If you mail the claim form, use "certified mail - return receipt requested" so you have a record of the date it was mailed and the date it was received. If you don't return the completed form to your employer, you may risk your right to benefits.

• Can I see a different doctor than has been assigned?

  The claims administrator has the right to select your treating doctor for the first 30 days after your employer knows that you were injured. After the first 30 days, you may be treated by a physician of your choice or at a facility of your choice within a reasonable geographic area. Choosing the right doctor is important and improves your chances of recovery and return to work.
  
  Most insurers have a Medical Provider Network (MPN) list from which you can choose a new doctor. An MPN is a group of physicians and other health care providers selected by the employer or insurer to treat injured workers. MPNs must be approved by the state Division of Workers' Compensation (DWC). Each MPN includes a mix of doctors specializing in work-related injuries and doctors with expertise in general areas of medicine. The claims administrator is required to give you a list of MPN doctors near you. After the first appointment, you are free to select another doctor within the MPN.

• What if my employer has an HCO (health care organization)?

  An HCO is an organization certified by the state Division of Workers' Compensation (DWC) to provide managed medical care to injured workers. HCOs must have health care providers who understand the workers' compensation system and occupational health care. If you choose to be in an HCO, the HCO will coordinate all aspects of your medical care for your work injury and will work with your employer to get you back to work.

• What should I do if the insurance company want me to pick a doctor from a Qualified Medical Evaluator (QME) Panel?

  IMMEDIATELY contact the Law Office of Cogan & Hanrahan when the insurance company talks about getting an evaluation and asks you to pick an evaluator. Such an evaluation has major consequences for your Workers' Compensation benefits. If you wait until after the evaluation to contact a lawyer, we may be unable to help you.

• How is my Workers' Compensation case resolved?

  Your case is resolved when there is an agreement between you and the claims administrator or a judge issues an order about your Workers' Compensation payments and future medical care that will be provided to you. In order to protect your rights, whether or not you are represented by an attorney, settlements must be reviewed by a Workers' Compensation administrative law judge in order to determine whether the settlement is adequate.

• What types of settlements are there?

  Stipulations with Request for Award ("Stips")

  • Payments - You and the claims administrator agree on the amount of temporary or permanent disability payments you will receive. This is usually paid in weekly payments.
  • Medical care - The claims administrator usually agrees to pay for medical care if needed.

   

  Compromise and Release ("C&R")

  • One Payment - The claims administrator agrees on an amount to resolve your claim. This is usually paid in a lump sum.
  • Medical care - If the lump sum includes the estimated cost of future medical care, the claims administrator will no longer pay your doctor. This is included in the payment you receive and becomes your responsibility.

• What if my claim doesn't settle?

  If you and the claims administrator are unable to agree on a settlement, your dispute will need to be decided by a Workers' Compensation judge.