San Francisco Workers Compensation Attorney

Workers’ compensation benefits are available to employees who suffer a wide range of work-related injuries or illnesses. The main criteria for workers’ comp coverage is that the injury or illness in question must be caused by the employee’s occupational duties.

Some of the many covered injuries include:

• Repetitive motion and overuse injuries, such as carpal tunnel syndrome or tendinitis
• Occupational illnesses caused by exposure to harmful substances
• Hearing loss from working in noisy environments
• Car accident injuries sustained while driving a work vehicle
• Workplace slip and fall accidents
• Certain psychiatric conditions like PTSD caused by high-stress occupations, such as police officers
• Pre-existing conditions that are worsened by work-related activities

Workers’ compensation is a no-fault system, meaning that workers may still receive benefits even if they are partially responsible for their own injuries. With that being said, workers may not collect workers’ compensation benefits if their injuries were the result of horseplay, drug or alcohol intoxication, the commission of a crime, or a violation of company policy. Likewise, injuries that are suffered off duty and off of company premises may not be eligible for coverage. For example, injuries suffered in a car accident while commuting to or from work are typically excluded from workers’ compensation.

In the overwhelming majority of cases, the employer has 90 days from knowledge of the claim to investigate and deny the claim. If more than 90 days pass, then the claim is presumed compensable. The presumption can only be rebutted by evidence showing that the employer (or insurance carrier acting on its behalf) discovered information that could not have been discovered in the initial 90 days of the claim.

An employer is in violation of LC Section 132a for terminating or discriminating against an employee for filing a workers’ compensation claim. While these claims are typically more difficult to prevail on, if you were improperly fired and do win, it could result in reinstatement of your position along with back pay.

While most claims are filed while the employee is still employed, it is not a strict requirement. It depends on several factors, such as whether you voluntarily quit, whether you suffered a specific injury or a cumulative trauma injury, and whether you obtained medical treatment for the illness or injury prior to leaving the employment.

A specific injury is typically a workplace accident where a sudden event occurs. It could be a slip-and-fall, a car accident, or simply bumping into something. Most of the time it is an obvious event, but it could be more subtle, such as a single exposure to toxic or radioactive materials. In other words, except for that single event, you would not have been injured. A cumulative trauma injury occurs when a series of workplace activities cause damage over time to a particular body part or process. The injury is often gradual but the onset of symptoms can be sudden. A stroke, a heart attack, or a ruptured disk back injury could all be examples of a sudden onset of symptoms. An apt metaphor often used to describe this scenario is, “the straw that broke the camel’s back.” When the symptoms are gradual but slowly increasing, many workers mistake the injury for something else unrelated to their workplace activities. For example, if a data entry office worker sits at a work station that is ill-designed, the worker may begin to feel gradually worsening symptoms in his or her neck and upper extremities. The worker may, at first, attribute these symptoms to the aches and pains of normal aging and discount the effect the work duties are having. Eventually, though, if the work station and duties remain unchanged, the symptoms will worsen to the point where medical treatment is required. At that point, a proficient medical professional will find the connection between the injury and the work duties. Many injured workers, and employers for that matter, are under the mistaken impression that cumulative trauma injury is somehow a less valid workplace injury than a specific injury. This is because a specific injury indicates a single, often significant, event; whereas the cumulative injury appears out of uneventful work duties. It is difficult for some employers to understand how an injury can be caused by cumulative trauma.

This is not uncommon and simply means that you will need to litigate the claim. You will need to obtain medical and factual support for the claim and, if the employer still will not accept the claim, file for a hearing at the WCAB. Each situation is different, so it is a good idea to consult with a workers’ compensation attorney in San Francisco or an Information and Assistance Officer at your nearby district office of the WCAB.

For the first 30 days after the claim is filed, the employer can direct the medical treatment with a few exceptions. After that, the injured worker can choose his or her treating physician although in most cases, the injured worker must choose from an established network of facilities and health care providers.

The key definitional difference is that temporary disability is a replacement for lost income because you cannot work while you are rehabilitating from your injury. Permanent disability is monetary compensation for residual disability after a medical determination has been made that you are finished recovering. There are many other differences in the way these benefits are calculated and applied.

Yes, as long as the claim is made in a timely manner, any dependent may seek death benefits. Certain members of an employee’s family such as the spouse or minor children are presumed to be dependent and have the right to file a claim.