My advice to them is simple:
1. First Get Your Workers’ Comp Claim Accepted
Workers’ compensation insurance carriers will often try to deny workers’ comp benefits and payments for several reasons. Either the injured worker fails to report the injury, or the insurance carrier concludes that the injury was not job related.
You can avoid both of those scenarios by keeping the following in mind:
- On-the-Job Injuries —In California, any injury should qualify for workers’ compensation coverage so long as it happened at your workplace or while you were “on the clock” outside of the workplace.
- Repetitive Stress Injuries — continually repeating a movement, such as computer keyboard work, can lead to repetitive stress injuries like tendonitis, bursitis, and carpal tunnel syndrome. This constitutes a valid claim for workers’ compensation benefits.
- Occupational Illnesses — Many work environments expose workers COVID variants or chemicals that later lead to severe illnesses and cancers. If contracted at work, this qualifies for workers’ compensation benefits.
2. Take control of your claim from the beginning. Always Accurately Document Your Case
Your first responsibility as a workers’ compensation applicant is to report your accident or illness to your employer at the soonest possible time. Then there are additional steps you can take to strengthen your case:
- When you report your injury to your employer you must accurately fill out the DWC-1 form. Your employer is required by law to provide this form to you. If they don’t, call the Law offices of Goforth & Lucas, and we will provide the form to you. 925-682-9500.
- Write down everything you remember about the incident. Keep a diary or at least calendar notes of major events in your case such as surgery, time off work, and prescribed medications. The insurance company’s attorney will eventually take your deposition and will question you about dates and events.
- Be careful what you say to the insurance carrier. From the beginning the adjuster will try to get information including recorded statement. Don’t give a recorded statement. It’s better to briefly confirm the information that you submitted on the DWC-1 form. Leave it at that. Defer other questions to your attorney. Remember that the adjuster is not on your side and is investigating you and your claim. This includes looking into your past, your record, your claims in other cases, and paying an investigator to gather unannounced “sub rosa” photographs and videos of your daily movements.
- Consult with a workers’ compensation attorney at Goforth & Lucas early on. Keeping an upper hand on your case from the beginning is important to maintaining a level playing field. What you do determines what disability benefits you will ultimately receive. Protect your rights. Call Goforth & Lucas for a free case evaluation. 925-682-9500.
I have practiced workers’ compensation law for over 40 years and can tell you that these steps do dramatically increase your chances of successfully collecting ALL of the valuable workers’ compensation medical and disability benefits that you are entitled to.
Goforth & Lucas is here to guide you through the process and fight for your maximum workers’ comp recovery.
3. If Your Comp Claim Is Denied, You Must File an Application for Adjudication with the Workers’ Compensation Appeals Board, and Commence the Qualified Medical Examination Process
Insurance companies will look for any technicality to deny your case. Insurance companies try to save money by taking advantage of a complicated benefit system which is codified in the California Labor Code. They want you give up early.
You will ultimately undergo an independent case review by a Qualified Medical Examiner to determine whether your case must be fully accepted by the insurance company, and what medical care, retraining, and disability payments you are entitled to. Sometimes a Workers’ Compensation Appeals Board (WCAB) hearing or trial is necessary to a determination and enforcement of your right to benefits.
4. Your right to full workers’ comp benefits is always worth the fight!
When insurance companies unreasonably deny your benefits, a WCAB judge is the final arbiter of your right to all workers’ comp benefits.