Ten Facts about Workers’ Compensation that You Should Know!

James Stern, Attorney-at-Law
Tosdal, Levine. Smith & Steiner

Workers’ Compensation is a scary topic for most people.

It’s scary because most people have not had to go through it and only know about it through second, third and fourth hand stories, most of which are incorrect and without a factual basis — “My friend’s sister’s cousin cut her finger and got $4 million.”

Employers too, are woefully uninformed about the system and make workers feel as though they are criminals for filing a claim.

Hopefully, this article will give you some information and knowledge about the workers’ compensation system.

It will not tell you everything, but you will know at least a few new things and the more you know, the less scary the system will be if you have to go into it.

Workers’ Compensation is a “no-fault” system.

There is no “fault” to be proven in most workers’ compensation cases.

The program was established to give employees injured at work a system that would somewhat take care of them, their medical expenses and prevent lawsuits against employers.

You do not need to prove that your boss or a co-worker did something wrong to claim and get workers’ compensation benefits. In most cases the fact that you are injured while or as a result of working, is all that is needed.

Workers’ compensation is a right, not a benefit.

The state of California requires that maintain workers’ compensation coverage for all of their employees.  Not having coverage is a misdemeanor!

The rationale was to make certain that every employed person in California, if injured while at work or as a result of work, would be able to have treatment and care.

Pain and suffering are not part of workers’ compensation.

Despite what you may have thought, there is no money paid in workers’ compensation to the injured worker for pain and suffering.

The only payment that is made in any award is for the amount of permanent disability the employee has suffered as a result of the work injury.

The system does not care about your home life and how your life has been affected.

The workers’ compensation system — perhaps unfortunately — does not care about how your family suffered as a result of your injury. It only cares about how much your ability to work in the open labor market has been reduced.

Don’t expect lots of money!

The WC system is designed to give injured workers money during the time that they cannot work.

The amount is two-thirds of the average weekly wage, up to a maximum of $490 per week.

While this is tax free, it is still not a lot of money and often less than the injured worker was getting when working.

Report every injury!

Employees tend to ignore minor injuries, either due to embarrassment or fear that their jobs will be jeopardized.

Don’t be! Your employer is required to respond with a claim form for all injuries. If it is minor, nothing happens. If it is major, you have protected yourself and started the clock running for the insurance company to admit or deny your injury.

An injury that is not denied within 90 days is deemed admitted!

You can choose your own doctor!

Insurance companies and employers like to intimidate workers and force them to use their doctors.

When an injury is admitted, the employer can control the doctor only for the first 30 days — after that, the employee can pick any doctor he or she wants. So long as the doctor is in the area, you are entitled to pick your own!

The insurance people are not always your best friends. There are a lot of very good, competent and honest insurance and employer adjusters in the workers compensation field.

But, as nice as some are, there are a great many who will not tell you all the facts you need to know or what your rights are. They work for the insurance company and insurance companies do not make money by giving it away.

The court approves attorney’s fees.

In workers’ compensation, the fees are between 12 and 15 percent and are approved by the court.

The court is there to protect the worker and so you are protected with both an attorney, if you have one, and a judge, even if you don’t have an attorney.