Employees who sustain injuries in the workplace or suffer from work-related illnesses can seek compensation. Depending on the circumstances, this compensation can come from the workers’ compensation insurance or third-party insurance. In some cases, it may be necessary to take the case to court.
Understanding the workers’ compensation case process in Fresno may not be easy. These cases are always surrounded by legal nuances. An experienced workers’ compensation attorney can provide advice and help achieve the desired outcome.
The first step in the Fresno workers’ compensation case process is reporting the injury to the employer. An employer must provide a claim form, which the employee has to fill out, attach the documents, and submit to the insurance company.
Next, the insurance company reviews the claim and assigns an adjuster to investigate the incident. If, after the investigation, the company approves the claim, the worker can receive a payout. If the claim is denied, the employee can file an application for adjudication of the claim with the Workers’ Compensation Appeals Board (WCAB) to appeal the decision.
If a third party causes the employee’s injuries at work, the latter has the right to file a personal injury lawsuit. While workers’ comp insurance can cover medical bills and a part of lost wages, it does not provide compensation for pain and suffering or full lost income.
To recover damages from the third party, the employee needs to file a claim with the at-fault party’s insurance company. However, unlike workers’ compensation claims, this one must be backed by evidence that proves negligence.
The workers’ comp case process in Fresno changes when there is a third party involved. Besides filing a claim for workers’ comp, the employee needs to gather evidence and initiate another legal process. An experienced attorney can help the injured worker file a claim and get the money they deserve.
The workers’ compensation case process rarely leads to a trial. However, this may happen for several reasons, including an insurance company denying coverage of the employee’s injury-related expenses.
A workers’ comp trial is an administrative hearing that takes place before a judge. In most cases, only a few people are present at these hearings, including the employee, the employer, and their legal representatives.
During the trial, the attorney will explain the case to the judge and present evidence. Then, the employee can be called to testify about injury-related circumstances. Most likely, the employer’s attorney will conduct a cross-examination. The judge will hear everyone out and make a decision. In most cases, the decision does not take more than a day.
The workers’ compensation case process in Fresno can differ depending on the circumstances of the case. A competent attorney can guide you through the process and help you avoid mistakes.
At Silberman & Lam, LLP, we have helped many employees receive fair compensation for their work-related injuries. Call us for a case evaluation today.
