Do I Need an Attorney

Workers’ Compensation benefits are supposed to be automatically paid to individuals who are injured on the job in California. In the event of a routine injury an attorney may not be necessary. The employer should refer the injured worker to a physician, unless one has been pre-designated. Temporary disability should be paid in the event the physician takes the injured worker off work. The carrier has 14 days to make the first temporary disability payment or to advise the injured worker that the case has been put on a delay status. Most routine injuries do not result in extensive disability and the injured worker returns to work without significant disability. An attorney is not necessary in order to initiate benefits in this situation.

In the event the employer questions whether the injury occurred on the job, the insurance carrier has 90 days to investigate the claim. The carrier usually takes the statement of the injured worker, obtains any relevant past medical records, notifies the injured worker to choose a Panel Medical Evaluator and arranges for a medical evaluation by that evaluator to determine whether the injury occurred as a result of industrial factors.

Insurance carriers know how to manipulate the Workers’ Compensation system to their advantage in order to limit benefits payout. An injured worker who attempts to handle a claim of serious injury on his own will be limited by his lack of knowledge of the system and will invariably receive lower benefits then a legally represented individual.

Most injured workers will need an attorney to represent them in any of the following situations:

1. The injury is serious and it is obvious that it will result in extensive disability;
2. The injury is actually denied by the insurance carrier;
3. Disability lasts for an extended period of time, approximately 90 days, without any definite release to the normal and customary occupation;
4. There is significant residual permanent partial disability, even though there is a return to normal and customary job duties; or
5. other situations where an injured worker feels overwhelmed by the system.