First Responders and Workers’ Compensation

We all owe a great debt to first responders.  First responders face great risks in their jobs on an everyday basis.  Police officers, firefighters, and paramedics never know what types of risks they may be facing when walking into any situation on their job.  Unlike most other jobs, first responders face unique challenges due to the impossibility of greatly reducing or even eliminating most on-the-job risks.  In recognition of the inherently high risk associated with first responders’ employment, California has some specific legislation concerning workers’ compensation uniquely for first responders.

One type of workers’ compensation law in California specifically for firefighters recognizes that not all injuries for firefighters are immediately apparent.  While some injuries may be obvious, such as concussions, burns, or broken bones, there are others they may not be.  If a firefighter develops lung cancer, heart disease, tuberculosis, or other lung problems, the injury is presumed to be a work-related injury.  This is an assumption that employees in other fields will not receive.  Moreover, under Labor Code 4850, a firefighter will be eligible to receive full salary for up to a year after sustaining a work-related injury.  This is different from workers in other industries, who would only be eligible to receive temporary or permanent disability payments, which amount to two-thirds of regular salary and are capped at a certain amount.

California law was also modified following the tragic mass shooting at the Las Vegas Route 91 Harvest Festival in October 2017.  There were 58 people killed in the shooting and 851 were injured.  Among those sustaining injuries were four off duty police officers from California.  Their workers’ compensation claims were denied because they were off duty and simply attending the concert when they were injured.  Labor code 3600.2 was amended in response to this.  Under the new law, an employer may cover these types of cases.  Moreover, the labor code specifically names those injured in Las Vegas at the mass shooting as being eligible for workers’ compensation benefits.  The law states that the law shall not preclude an employer from accepting workers’ compensation liability when an employee is injured while outside of California while attempting to apprehend a suspected law violator or while attempting to protect others.

We have experience assisting our clients understand the various provisions of the California labor code and how it impacts your business.  Contact us today for a consultation.

Investigating a Workers’ Compensation Claim

There are many important components of a workers’ compensation case.  Proper paperwork, obtaining medical treatment, and sorting out reasonable and necessary accommodations are just a few examples.  Investigating a workers’ compensation claim is also an important component.

When an employee sustains a work-related injury, the first step is, of course, to make sure that employee receives the necessary, immediate medical treatment.  Once it is confirmed that the situation is no longer an emergency, the employer can then turn to the administrative side.  An employer is required to provide the workers’ compensation claim form to the employee within one working day of being notified of the injury.  The employer should also move forward to an investigation.

Investigating a workers’ compensation claim does not mean that you suspect the injured employee of lying or taking other fraudulent action.  Moreover, regulation 10109(a) provides that a claims administrator “must conduct a reasonable and timely investigation upon receiving notice or knowledge of an injury or claim for a workers’ compensation benefit.”  This means that an investigation is not just advisable, but required.  If the investigation is not completed within the time limit, then section 5401 provides that the injury shall be presumed to be compensable under workers’ compensation.

A proper investigation often means collecting evidence from more than one source.  If there is video surveillance covering the area where the employee sustained an injury, that video surveillance footage often provides crucial and best information about how the injury occurred.  Eye witness accounts also may provide important information.  Eye witness accounts should be gathered immediately, as the longer you wait to record that information, the less likely it is that the witness statements will be completely accurate.  An investigation can also include talking with other employees or supervisors who work in the same area, even if they did not witness the event.  They may have information about how work is usually performed, how equipment functions, and the likelihood that the injury occurred in the manner explained by the injured employee.

An investigation can and should also include a review of social media.  Although the vast majority of workers’ compensation claims are valid, a small percentage are fraudulent.  Following social media can provide claims administrators or employers with clues that the employee is not as injured as claimed.

We have extensive experience in workers’ compensation cases ranging from minor injuries to death of an employee. Contact us today for a consultation to talk about your business.

Most Common Workplace Injuries

Unsafe working conditions can result in injuries to employees, ranging from minor to severe.  Most employers spend considerable time and effort trying to ensure their business is as safe as possible to prevent injuries to employees and clients alike.  When taking these steps, employers should keep in mind some of the more common types of workplace injuries, as this can help employers take the focused efforts necessary to prevent these injuries.

Back and neck injuries from lifting heavy objects are among the most common workplace injuries.  Almost fifty-seven thousand workers per year in California are injured at work when they are lifting heavy objects at work.  Employers should take measures to make sure their employees are educated about safe lifting techniques and are provided with the appropriate safety equipment, such as weight belts.

Another very common type of injury is a repetitive motion injury.  Work that requires repeated motions can result in nerve, muscle, tendon, or ligament damage.  Most people are familiar with carpal tunnel syndrome, which is a type of repetitive motion injury.  It is not, however, the only type of repetitive motion injury.  Any type of task which requires an action that is repeated over and over can result in this type of injury, such as reaching, twisting, or even lifting.

Slip and fall injuries are the third most common workplace injury reported in California, with about 30,000 people per year injured in this way at work.  It is not uncommon for there to be wet or slippery floors in some types of work environments, such as dishwashing areas in restaurants, pool decks at a gym, or wet pavement after a rainstorm.  Even if the employer is not responsible for the conditions that lead to the slippery conditions, the injured worker can still apply for workers’ compensation benefits.

Cuts and scrapes are also very common work-related injuries.  Minor cuts or scrapes may not require anything more than a bandage, but some lacerations can be very serious, even requiring surgery to repair and physical therapy to completely recover.  Almost twenty thousand workers a year in California file for workers’ compensation benefits due to cuts or scrapes.

We have experience with helping our clients understand their obligations to their employees in the workers’ compensation context.  Call us today for a consultation.

Lost Wages and Medical Costs – What Type of Benefit Will My Employee Receive

The workers’ compensation system is designed to help protect and help both employees and employers.  The employer is protected because when an employee sustains a work-related injury, the employee can usually only recover benefits through the workers’ compensation system.  In other words, the employee typically cannot file a civil suit against the employer for negligence.  An employee is protected because he or she does not have to prove fault or negligence on the part of the employer in order to obtain benefits.  If you own a business, it is important for you to understand the types of benefits your employee may receive.

One of the most obvious types of benefits that the employee will receive is medical costs for treatment of his or her injury.  The medical treatment benefits will include the costs of treatment for an acute injury, such as going to the emergency room or emergency surgery.  What some employers fail to realize, however, is that the covered medical expenses will also include ongoing expenses, such as physical therapy, acupuncture, or medical equipment.  If the injury is a mental injury, such as post-traumatic stress disorder, the medical costs would also include psychiatric care.

Temporary disability benefits are another type of benefits that will be awarded.  Temporary disability benefits are designed to provide a replacement for the lost wages for the time during which an employee is not able to return to work after sustaining a work-related injury. An employee will receive two-thirds of his or her average weekly pay for up to 104 weeks within five years of the date of the injury.

Permanent disability is not designed to address the same issue as a temporary disability.  Permanent disability is designed to address a permanent loss of function that the employee experiences as a result of the work-related injury.  The amount the employee receives will depend on the degree of disability, as determined by medical professionals, up to two hundred ninety dollars a week.

Workers may also be eligible for job displacement benefits.  If a worker is permanently disabled and as a result cannot return to his or her job, then he or she may apply to receive a voucher for retraining.  The injured worker can go back to school to be trained for a new position.

We have extensive experience helping our clients understand the benefits in a workers’ compensation case and what that means for their business.  Call us today for a consultation

Time Limits in Workers’ Compensation

Most people understand that there are time limits in almost all types of legal cases, ranging from prosecution of domestic assault to suing for breach of contract.  Workers’ compensation is no exception.  There are time limits that need to be observed at many stages of the workers’ compensation case.  As an employer, you need to be familiar with some of these time limits to make sure you are properly observing the law and understand your rights and responsibilities.

The first time limit you should be aware of concerns the reporting of the injury.  When your employee sustains a work related injury, he or she is obligated by law to report that injury to you.  The employer is obligated to report the injury to the employer within thirty days of sustaining the injury or becoming aware of the injury.  The employee needs to fill out a DWC-1 claim form providing details about the injury.

Another essential time limit to be aware of is that reporting an injury to the employer is not the same as filing a claim for workers’ compensation benefits.  Under California labor code 4906(g), the injured employee is obligated to file an Application for Adjudication of Claim and Declaration with the workers’ compensation appeals board to start the case.  The worker must file this application within one year of the job-related injury or illness.  If the employee fails to meet this time limit, he or she may lose the right to file a case at all.  Once the case is commenced, there is no time limit on how long the case can last.  In the optimal circumstance, the procedure will go smoothly and it can be concluded without too much trouble.  The increasing use of alternative dispute resolution helps conclude cases quicker and with more efficiency than in the past.  If no settlement can be reached, however, the case can last for months or even longer.

There are some limited circumstances when the statute of limitations may be extended.  One common situation when this may happen is where the injured employee is under eighteen at the time he or she is injured on the job.  In that case, the statute of limitations is “tolled” and does not start to run until the injured employee turns eighteen.  Another common exception is for repetitive stress injuries, such as carpal tunnel syndrome.  In those types of cases, the statute of limitations starts to run from the date the employee became aware of the injury and also became aware the injury was a result of employment.

We have extensive experience with helping our clients understand the necessary procedures in workers’ compensation case.  Call us today to discuss your case and what we can do to help.

How OSHA and Workers’ Compensation Interact

Employers likely understand that there are many rules and regulations concerning workplace and employee safety.  Employers must take proper steps to make sure that employees are working in safe conditions that comply with state and federal law.  In California, employers are also obligated to maintain workers’ compensation insurance, with very few exceptions.  Employers need to make sure that they comply with both the California workers’ compensation system as well as other regulations regarding work place safety.  It is important for employers to grasp how workers’ compensation interacts with the California Division of Occupational Safety and Health, also commonly called Cal/OSHA.

Cal/OSHA is administered by the Department of Industrial Relations.  The purpose of Cal/OSHA is to ensure healthy and safe working conditions and protect public health and safety.  They do this by propagating regulations in California workplaces, including amusement park rides, ski lifts, and elevators.  Certain qualifying organizations have injury and illness prevention programs.  These programs are intended to identify risk factors and eliminate dangers before injuries or illnesses happen.  In addition to creating safety regulations, Cal/OSHA also provides safety and health assistance programs to employers and workers including on-site assistance and consultation.

By contrast, the workers’ compensation system is not an administration and does not independently create its own regulations.  Instead, workers’ compensation regulations come from the California legislature.  The workers’ compensation system is not designed to prevent injuries before the occur. Instead, the workers’ compensation system provides wage replacement, medical expenses, and sometimes vocational training for employees who have sustained work related injuries.  The California workers’ compensation system is a “no fault” system, which means that employees are not required to prove the work related injury resulted from any intentional or negligent conduct on the part of the employer; the worker is not required to demonstrate that the employer violated any safety regulations, including those created by Cal/OSHA.

The safer the work place, the less likely it is the employees will sustain work related injuries.  Avoiding work place injuries clearly benefits everyone, and can help the employer keep their insurance rates low.

We have experience with the workers’ compensation system and can talk to you about those regulations and Cal/OSHA.  Call us today for a consultation

Beware of Incorrect Worker Classification

Employers know that there are many administrative responsibilities they must give special attention to.  This includes such issues as paying taxes, making sure you comply with any local ordinances, and keeping your inventory up to date, just to name a few.  Employers are also free to determine how they want to accomplish their work.  Employers can hire employees to work directly for their business.  Alternatively, they can retain the services of an independent contractor.  It is essential that employers properly classify their workers.

Under the California workers’ compensations system, an employer is required to provide workers’ compensation insurance for all employees.  The failure to provide the required insurance can result in hefty civil penalties and in some cases, even criminal charges.  However, an employer is not required to provide workers’ compensation insurance for independent contractors.  To that end, many employers end up classifying all of their workers as independent contractors to try to get out of providing insurance and benefits.  Like the failure to provide insurance coverage at all, the misclassification of workers as independent contractors can carry heavy repercussions.  If it is discovered that a worker is misclassified, California law provides that an employer may have to go back and pay unpaid payroll taxes that were avoided because of the misclassification. California law also provides for civil penalties starting at $5,000 for each misclassification and go up from there.  Moreover, the misclassified worker can seek up to three years of back wages, including unpaid overtime.

It is clear that employers need to be diligent in their proper classification.  However, there is not exactly a set definition of “independent contractor” versus “employee,” although employee is defined in labor code section 3351. That said, there are several issues the court will examine when trying to decide whether a worker is an independent contractor.  One of the most important issues is what type of control the worker has on how his or her work is completed.  For example, if the employer sets specific times when the worker must do the work as well as a particular place, that indicates the worker is actually an employee.  Another indication is if the employer provides the tools and equipment necessary to complete the work, the worker may actually be an employee and not an independent contractor.

We have experience assisting our clients understand worker classification.  Contact us today to talk about your business and what we can do to help make sure you are in full compliance with the law

Why Do We Have Workers’ Compensation?

Conscientious employers take many measures to make sure that their employees are safe in the work place.  Providing training, keeping equipment in good repair, and forming safety committees are just a few ways that employers can help keep their workers safe.  In the event that a work related injury occurs despite these measures, the workers’ compensation system comes into play.  The workers’ compensation system is a complex series of statutes and case law that has evolved over time.  Understanding why we have this system can help employers and employees alike better comprehend their rights and responsibilities in the context of workers’ compensation.

Workers’ compensation provides protection for both employees and employers.  When an employee sustains a work related injury, it could mean that he or she is completely unable to work and provide for his or her family.  With workers’ compensation, the employee is able to still receive income.  The employee can also receive reimbursement for reasonable medical expenses.  This is designed to help the employee heal so he or she can return to work as soon as possible.  With workers’ compensation, the employee is also protected from the employer taking retaliatory action due to filing a workers’ compensation claim.

An employer also enjoys protection under this system.  The California workers’ compensation system is a “no fault” system.  This means that the employee does not have to prove that the injury occurred as a result of the negligent or intentional conduct of the employer.  The other side to this, however, is that the employee is typically barred from filing a tort claim against the employer to recover for the injuries.  Instead, the employee must seek recompense for injuries through workers’ compensation.  This protects the employer from repetitive or even frivolous law suits.

It is important to remember that for many years, there were no health or safety standards for work place conditions.  As a result, employees were frequently injured or even killed on the job, and their families would have no method of redress.  The workers’ compensation system helps make sure that employers are incentivized to keep their business safe, and employees are not able to make a “double recovery” by suing in tort as well as receiving benefits.

We have extensive experience with the workers’ compensation system and explaining an employer’s rights and responsibilities.  Contact us today for a consultation.

Origin and Purpose of Workers’ Compensation

The majority of employers take many measures to help make sure their employees are as safe as possible at work.  Employers may decide to provide extra safety training, purchase and install safety technology, or form safety committees, just to name a few examples.  Unfortunately, despite the most diligent efforts, it is likely that at some point, an employee will sustain a work-related injury.  When that happens, the employee may file for workers’ compensation.

The modern workers’ compensation system can trace its origin to the Workers’ Accident Insurance system that was put into place by Otto von Bismark in 1881.  The motivation behind enacting this system was what was referenced as the “unholy trinity” of tort defenses that were available at that time, including contributory negligence, assumption of risk, and the fellow servant rule.  In other words, it was much more difficult for injured employees to be compensated if they were injured on the job.

Different states here in the United States started implementing workers’ compensation systems before the turn of the century, with the first state-wide system being instituted by Maryland in 1902.  Workers’ compensation provided a much needed outlet for injured employees to seek compensation for industrial injuries.  The workers’ compensation system is designed to protect both the employer and the injured employee.  Workers’ compensation in California is a “no fault” system.  This means that the injured employee does not have to prove the injury was a result of negligence or intentional acts on behalf of the employer.  Similarly, the employer is protected from law suits from the employee, with only a few exceptions.

It is no secret that at the turn of the century, industrial working conditions for most Americans were quite dangerous, with few regulations in place to require employers make sure their workers were safe.  Especially in factories or manual labor fields, it was common for employees to sustain truly horrific injuries.  By instituting worker’s compensation, employers were motivated to make sure their businesses were as safe as possible for their employees.  In addition, employers could feel at ease knowing that their employees could not sue for negligence if the employee sustained an injury because the employer overlooked some safety measure.

We have extensive experience helping our clients understand the workers’ compensation system.  Call us today to talk about what we can do to help you.

Acupuncture, Chiropractors, and Workers’ Compensation

After an employee sustains a work-related injury, there are many steps that will need to be taken, ranging from paper work to reporting the injury to insurance company to reporting certain injuries to state and federal entities.  One of the most important steps is making sure that an employee receives proper medical treatment.  Although some medical treatment may involve addressing acute and emergent injuries, such as a broken arm, other treatment plans may include more long-term types of treatment, such as physical therapy.  Some workers may elect to pursue alternative treatments.  Two of these treatments are acupuncture or going to a chiropractor.

Acupuncture is a form of alternative medicine with roots in China.  With acupuncture, tiny needs are inserted into the patient’s skin at very particular, key points.  Practitioners of acupuncture believe that proper practice can alleviate stress or pain.  Under the California Labor Code 4600, acupuncture is recognized as a valid treatment for work-related injuries. The labor code provides that an authorized practitioner of acupuncture may apply to become certified as a health care organization to provide treatment to injured employees.

Chiropractic care is based on manipulating and realigning joints, especially those in the spine.  Practitioners believe that proper chiropractic care can help address disorders affecting nerves and muscles.  As with acupuncture, California Labor Code 4600 provides that chiropractic care is a valid treatment course for workers’ compensation.  Unfortunately, many employers have reported negative experiences with some chiropractors.  In the past, some unscrupulous chiropractors would continue to make sure the injured worker came back for as many treatments as possible to maximize the money he or she could make from the patient.  In response, California law now provides that chiropractic visits shall be capped at twenty four for each industrial injury, unless the employer authorizes additional visits.  This law was passed in response to the fact that past studies revealed that workers’ compensation cases involving chiropractic care often paid out more than thirty percent more than other cases, and tended to last longer.  The law is intended to address the fact that many chiropractors often recommend chiropractic care as a life long course of care, and some were attempting to draw out treatment far after was actually needed for the work related injury.

If you have questions about what type of care is appropriate or available for your injured worker, call us today.  We have extensive experience helping business owners understand their rights and responsibilities under California law.

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