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Various injuries are possible on the job, from broken bones and sprained backs to falls, explosions, and chemical burns. If you are in a high-risk profession, such as a safety officer, the possible injuries may be even more devastating. If you are hurt on the job, the first thing to remember is that your employer may be required by local law to provide workers’ compensation benefits.
The benefits you may be entitled to include medical care for your workplace injury. If you were severely harmed while in the scope of your employment, contact 911 immediately. In all cases, seek medical treatment after a workplace injury in Santa Ana occurs. Per workers’ compensation rules, you must report your injury to your supervisor as soon as possible due to the statute of limitations around preserving your claim. These requirements may be complex to understand alone, but a workers’ compensation attorney could guide you through the legal processes and help determine if you are eligible for benefits.
Once a worker has reported their injury to their employer and receives the necessary medical care, they should receive a Workers’ Compensation Claim Form (DWC 1), which their employer must provide within one day of the reported injury. Both the employee and employer are supposed to sign this form. The DWC 1 includes information about the injury and medical treatment received from the worker’s physician.
All benefits are decided by a claims administrator who can accept or deny the claim. Denied claims usually mean the administrator does not believe workers’ compensation insurance covers the injury.
This could happen, for instance, if an employee has a heart attack at work but has a pre-existing heart condition. However, even with a pre-existing heart condition, the employee may have suffered an industrial injury. An attorney can help to appeal these denials.
A claims administrator may deny an injury claim if they do not believe that work caused the injured worker’s injury.
When this happens, either party could ask for a qualified medical examiner (QME) review. This review may send an injured employee back to the doctor for additional medical treatment and diagnosis. A Santa Ana work injury attorney could help an employee get the medical treatment they need by assisting them with filing an Application for Adjudication of Claim.
Whether a claim is denied or the apportionment of the injury is disputed, the injured employee must submit to additional medical testing by an approved physician. The QME will evaluate the patient’s medical treatment and past medical history to determine the source of the injury and how much is attributable to their profession. In many cases, it is important to consult with an attorney before you see, or choose a QME, a Santa Ana attorney could help employees obtain a QME to pursue benefits for their work-related injuries.
If the parties are unable to resolve the case, they can proceed to a court hearing. Before going to trial, the parties first need to go to a Mandatory Settlement Conference before a judge. If an agreement cannot be reached at that conference, the judge will pass the case to a trial judge, who will hold a trial and issue a decision. An attorney could assist an injured employee through every step of the ensuing legal process to obtain the medical treatment they need.
If you have been injured on the job, it is vital to get medical help as soon as possible. Even if you believe your injury is minor, failure to report the incident to your supervisor or get medical treatment could prevent you from obtaining any workers’ compensation. If you are unsure of how to proceed in your unique case, a local attorney could help.
Filing a claim for benefits is a complex process. If you are denied, a workers’ compensation lawyer could act as an advocate in settlement talks and at trial. Call our office today after seeking medical treatment for a workplace injury in Santa Ana.