Workers’ Compensation in California: Self-Representation vs. Hiring an Attorney, Which One Is Best?

The California Workers’ Compensation system is designed to provide injured workers with the immediate medical attention and financial benefits they need after suffering work-related injuries or illnesses.

When navigating the system, injured workers have a choice: they can choose to represent themselves, which is referred to as pro per, or seek the assistance of an applicant attorney licensed in the state of California. In this comprehensive article, we will explore the options of self-representation and hiring an applicant attorney in the California Workers’ Compensation system.

We will also discuss the pros and cons of self-representation, examine the advantages and disadvantages of hiring an applicant attorney, and delve into whether injured workers who seek the help of the best workers compensation attorneys in Riverside County, CA, and the rest of California recover higher financial settlements as opposed to injured workers to represent themselves pro per. Read on.

Workers' Compensation in California: Self-Representation vs. Hiring an Attorney, Which One Is Best

Section 1: Self-Representation in California Workers’ Compensation

Pros of Self-Representation

  1. Cost Savings: One of the primary advantages of self-representation is cost savings. By representing themselves, injured workers do not have to pay attorney fees, which are only 15% and regulated by the Worker’s Compensation courts. And, of course, the obvious advantage would be the injured worker would be able to retain the entirety of their benefits and settlements and not have to pay a 15% representation fee to an applicant Lawyer.
  2. Simplified Process: For straightforward workers’ compensation claims with clear injuries and straightforward circumstances, self-representation can be relatively simple. In such cases, workers may not need legal expertise to navigate the process. The problem is, the Worker’s Compensation system in California is extremely complex and establishing if your Worker’s Compensation claim is a straightforward circumstance, would at minimum be best decided through a free consultation with an applicant attorney.
  3. Full Control: Self-represented individuals have full control over their cases. They make all decisions, including whether to accept settlements, attend medical evaluations, or dispute decisions made by the insurance company or employer. Additionally, an injured worker in the state of California, also has the ability to opt out of the Worker’s Compensation system, and use their own private insurance. Mini injured workers find the workers compensation system in California to be cumbersome and unfair, and prolonged treatment and settlements are very common.
  4. Timely Resolution: In some cases, self-represented individuals may be able to resolve their claims more quickly because they can make decisions promptly without waiting for attorney consultations. Unfortunately, there’s strong evidence to prove that the injured workers that do settle their cases in a “timely manner”, unfortunately, are getting a much smaller financial settlement than a represented injured worker who was to pay 15% to their attorney for representation.

Cons of Self-Representation

  1. Complexity of the System: The California Workers’ Compensation system is complex, with numerous rules, regulations, and legal procedures. Navigating this system without legal expertise can be challenging and may result in missed opportunities or benefits. In fact, the California Workers Compensation system is just as complex as the criminal system. And in the criminal system, it is a law that you are provided a lawyer through the public defender’s office. The same option should be offered to injured workers.
  2. Limited Knowledge: Injured workers may not fully understand their rights and the benefits they are entitled to. This lack of knowledge could lead to accepting inadequate settlements or benefits. The reality is that the vast majority of injured workers do not have any knowledge of how the intricate Workers’ Compensation system works in California, leaving them stuck at the mercy of their insurance companies. And as we all know, insurance companies are profit organizations looking to always spend less and make more.
  3. Potential Mistakes: Without legal guidance, injured workers may make mistakes in filing paperwork, meeting deadlines, or gathering necessary evidence, which could negatively impact their cases. This is definitely a big problem injured workers run into when they self-represent or go pro per. Again, the Worker’s Compensation system in California is a complex maze of rules and regulations and deadlines. The smallest mistake could cost an injured worker thousands of dollars. In some cases, they could even lose their job by not complying with the law correctly.
  4. Negotiating with Insurers: Self-represented individuals may struggle to negotiate effectively with insurance companies, which often have experienced adjusters and attorneys advocating for their interests. In this instance, injured workers that represent themselves pro per have essentially no idea what their case is worth. In addition to this, they have no medical knowledge at all. And since they’re allowing the insurance company to choose the doctors that are treating them, they’re going to be at a massive disadvantage when it comes to reporting permanent disability that would bring them a higher financial settlement and also getting the injured worker to maximum medical improvement.

Section 2: Hiring an Attorney in California Workers’ Compensation

Pros of Hiring an Attorney

  1. Legal Expertise: Applicant attorneys specializing in workers’ compensation have in-depth knowledge of the system’s intricacies. They can ensure that injured workers understand their rights and receive the benefits they deserve. In many cases, applicant attorneys, representing injured workers, or former employees of insurance companies. Therefore, they understand all the different tricks and methods to devalue a case, prolong treatment, and avoid making a fair financial settlement in a timely manner.
  2. Strategic Guidance: Applicant attorneys have much more experience, and can develop a strategic plan for each case, maximizing the odds for an injured worker to receive a favorable outcome. California applicant lawyers can negotiate with insurance companies, gather evidence, and present a compelling case. And if the insurance company is not cooperative at all, or the applicant attorney, representing the injured worker, cannot come to a fair settlement with the insurance company. Then the applicant attorney can take the case to trial, and potentially recover a substantial amount of money for the injured worker they are representing by taking the case in front of a judge. In some cases, insurance companies operating with lack of integrity are often sanctioned by Worker’s Compensation judges to prevent malfeasance in the future.
  3. Assistance with Complex Claims: In cases involving complex injuries, disputes, delayed cases or denials, an applicant attorney’s expertise is invaluable. An aggressive, experienced and ethical applicant lawyer is capable of navigating complex legal issues and advocate for their clients’ best interests.
  4. No Upfront Fees: In California, workers’ compensation applicant attorneys always work on a contingency fee basis, meaning they only get paid if their client receives a financial settlement. There are no upfront fees for the injured worker, ever. It’s also important to know that all applicant lawyers in the state of California offer, free initial consultations, which are incredibly valuable to find out what the possible worth of an injured worker’s case may be, and the vast majority of applicant lawyers will inform an injured worker if it’s something they should handle themselves or will they get maximum benefit by hiring an applicant lawyer.

Cons of Hiring an Attorney

  1. Legal Fees: While attorneys work on a contingency fee basis, the fees for Worker’s Compensation or incredibly fair with a set fee at 15% of the total settlement. Some injured workers make the assumption that lawyers take the majority share of the settlement when winning the Worker’s’ Compensation system, but the reality is that these lawyers make the lowest percentage of all contingency-fee lawyers in all areas of law practice.
  2. Dependency: Injured workers who hire attorneys may become dependent on legal counsel for all decisions, potentially relinquishing some control over their cases. This can be a problem. If the wrong applicant lawyer is retained. That is why it is important for all injured workers to carefully research an applicant lawyer before they hire them for representation.
  3. Lengthened Process: In some cases, involving attorneys may extend the time it takes to resolve the claim due to legal procedures and negotiations. Well, this is true, and some lawyers do lengthen the process of the settlement, because they are incompetent or inefficient. The vast majority of cases that experience a prolonged settlement are due to the fact that the insurance company is unwilling to offer a fair financial settlement to the injured worker. At this point, the injured workers, applicant lawyer will typically discourage them from settling for a much smaller amount and continue to negotiate, and if necessary, go to trial to settle their case.

Section 3: Do Injured Workers Recover Higher Settlements with Attorneys?

The question of whether injured workers who seek the help of applicant attorneys in California recover higher financial settlements is a complex one. Several factors come into play:

  1. Negotiation Skills: Applicant lawyers are skilled negotiators who can the vast majority of the time secure higher financial settlements than self-represented individuals. Aggressive, experienced applicant lawyers know how to assess the value of a case and push for maximum compensation. Again, the importance of hiring a reputable ethical and aggressive Worker’s Compensation lawyer, or so important. The best applicant lawyers are well-known by the insurance companies and are more likely to settle cases quicker than attorneys of lesser skill. Among other reasons, this is due to the fact that insurers know the experienced lawyer is not going to cave to an unfair financial settlement amount.
  2. Access to Experts: California applicant lawyers have access to medical experts and the appropriate medical experts to get second opinions from and vocational rehabilitation specialists who can provide expert opinions and evidence to support the injured worker’s claim. California applicant lawyers also have valuable knowledge when it comes to picking a doctor for a qualified medical exam or choosing a doctor for an agreed medical exam. If an individual is representing themselves properly they’ll have no understanding of what the reputation is of the medical legal doctor conducting the medical legal evaluation. They can make the mistake and choose a doctor that has a reputation for leading and advocating more for the insurance company than the actual injured worker.
  3. Complex Cases: In complex cases involving severe injuries, multiple parties, or disputes, California applicant attorneys are invaluable in ensuring the injured worker’s rights are protected and they receive the compensation they deserve. If an injured worker is to represent themselves pro per, a complex case will go totally over their head, and they can certainly not rely on the insurance companies case managers and adjusters to help them go in the right direction of a higher financial settlement. That is why it’s important to always, at minimum, get a free consultation with a California Workers’ Compensation attorney to find out what the potential settlement of an injured worker‘s case could be.
  4. Challenges from Insurers: Insurance companies have experienced adjusters and attorneys working to minimize payouts. Having an experienced applicant lawyer on the workers’ side levels the playing field, making it more likely that the injured worker will secure a fair settlement. There’s a well-known saying in the legal industry. The insurance companies have aggressive lawyers, you should too.
  5. Legal Knowledge: Applicant attorneys in California are well-versed in workers’ compensation laws and regulations. This experience, applicant lawyers can identify opportunities for additional benefits that a self-represented individual might miss.
  6. Case-Specific Factors: The outcome of any workers’ compensation case depends on its unique circumstances, including the severity of the injury, the quality of evidence, and the diligence of the attorney. Self-representation typically ends up in the injured worker, finally hiring an applicant attorney due to the fact that, towards the end of settling their case, they learned that the insurance company is not being fair. At that point most injured workers will reach out to an experienced lawyer, and hire them to wrap up their case, and get them the highest financial settlement possible.

It’s important to note that while attorneys can enhance the likelihood of a higher settlement, there are no guarantees. Settlement amounts depend on various factors, including the nature and extent of the injury, the impact on the worker’s ability to earn, and the strength of the evidence presented.

Who are the best workers compensation attorneys in Riverside County, CA & the rest of California?

In the California Workers’ Compensation system, injured workers have the choice to represent themselves or hire an applicant attorney. The decision should be based on the complexity of the case, the severity of the injury, and the individual’s comfort level with navigating a complex legal system.

While self-representation can save costs and provide control, it may lead to challenges in understanding the system and maximizing benefits. Hiring an experienced applicant attorney in Riverside County and other parts of California offers the legal expertise, strategic guidance, and the increased potential for higher settlements, but it comes with legal fees, that are again nominal, set regulated fees at 15% of the total settlement. The injured worker will always receive 85% of the total settlement.

Ultimately, the choice between self-representation and hiring an applicant attorney depends on the individual’s specific circumstances and preferences. Legal counsel can be especially beneficial in complex cases and even the simplest cases, if the injured worker has absolutely no knowledge of how the Worker’s Compensation system works in the state of California, again even in straightforward cases, consulting with an attorney can help injured workers understand their rights and make informed decisions.

For a free initial consultation, please call California Workers Compensation Lawyers, APC. One of our dedicated legal professionals will be able to set you up with a free, initial consultation via telephone, all video, chat, conference, platforms, or in person by appointment only.

You can also find a wealth of information on our website, such as our explanation of California’s subsequent injury benefits trust fund and state fund insurance firms in California and beyond. Whatever you decide, always remember that the insurance company has aggressive lawyers. You should too!

How Does the Subsequent Injury Benefits Trust Fund (SIBTF) Work In California?

The Subsequent Injury Benefits Trust Fund (SIBTF) in California is a critical component of the state’s workers’ compensation system. It provides additional benefits to workers who sustain subsequent injuries in the workplace when they already have a pre-existing disability or impairment. 

To understand how SIBTF works, it is strongly recommended that you reach out to the best workers compensation lawyer in Riverside County, CA, and discuss your situation with them directly. To aid you in obtaining the compensation you’re rightfully entitled to, we have provided a breakdown of the qualification process and the steps involved in finishing a settlement. Read on.


Qualifying for SIBTF Benefits:

To qualify for benefits from the SIBTF in California, a worker must meet specific criteria. Here are the key factors that determine eligibility:

1. Pre-Existing Permanent Disability:

The worker must have a pre-existing permanent disability or impairment. This could be a result of a prior work-related injury, a non-work-related injury, or a congenital condition. The pre-existing disability may involve physical or mental impairments.

2. Subsequent Work-Related Injury:

The worker must then sustain a subsequent work-related injury. This injury must result in a permanent disability as well. It’s important to note that the subsequent injury does not necessarily have to be the same type of injury as the pre-existing disability. Any work-related injury that leads to a permanent disability can qualify.

4. Combined Disability Threshold:

The combined disability resulting from the pre-existing disability and the subsequent injury must meet or exceed a specific threshold. In California, this threshold is generally set at 70%. This means that the combined impairment ratings for the pre-existing disability and the subsequent injury, when added together, must equal 70% or more.

5. Apportionment Considerations:

Apportionment refers to the process of dividing the disability between the pre-existing condition and the subsequent injury. It is determined by medical evaluations and is subject to legal and medical rules. In some cases, if the pre-existing disability is found to be partially responsible for the combined disability, the SIBTF benefits might not apply.

Steps Involved in Settling a SIBTF Case:

Once a worker qualifies for SIBTF benefits, they may decide to pursue a settlement. Here are the steps typically involved in settling a SIBTF case:

1. Consult With an Experienced SIBTF Attorney:

It is highly recommended that the injured worker consults with an experienced workers’ compensation attorney specializing in SIBTF cases. An experienced SIBTF attorney can provide sound invaluable guidance throughout the entire SIBTF process, ensuring that the worker’s rights are protected and that the injured worker will receive the maximum benefits to which they are entitled under the labor code.

2. An Injured Worker Must File a Workers’ Compensation Claim:

If a worker in California sustains a work-related injury, they must report the injury to their employer as soon as possible and demand to seek medical attention. The employer is required by law to initiate a workers’ compensation claim, which will be evaluated by the insurance company providing the workers compensation insurance for the employer.

3. Medical Evaluation and Disability Rating:

A medical evaluation will be conducted to assess the extent of the worker’s disability. Disability ratings will be assigned based on the American Medical Association’s (AMA) Guides to the Evaluation of Permanent Impairment. This rating will help determine the amount of compensation the worker is eligible for.

4. Identification of Pre-Existing Disability:

During this process, the pre-existing disability or impairment will be identified and evaluated by the primary treating physician or a medical legal panel, such as a QME or an AME. Medical professionals and attorneys will assess the nature and severity of the pre-existing condition. Medical professionals will submit their findings to the insurance company case manager.

At that point the case manager will decide if the disability the medical professional has assigned to the injured worker is something they agree with. Typically, the insurance companies do not take the recommendation of a medical professional, unless it is an agreed medical examination in which both parties agree that the physician and his or her rating is final.

5. Combined Disability Rating:

The combined disability rating will be calculated, taking into account both the pre-existing disability and the subsequent work-related injury. If the combined rating meets or exceeds the 70% threshold, the worker may be eligible for SIBTF benefits. 70% is the threshold for an injured worker to receive a financial settlement. However, in order to qualify for a subsequent injury, the injured worker must have a WPI of 35% or greater or 5% bilateral disability to corresponding body parts.

6. Negotiations and Settlement Agreement:

The injured worker’s attorney will engage in negotiations with the SIBTF administrator, which is a state attorney assigned to each case who also handles unemployment insurance cases. The applicant attorney, representing the injured worker, and the lawyer, representing the state of California and the SABTF fund will work to reach a settlement agreement that outlines the terms of the compensation, including the amount and method of payment.

7. WCAB Approval:

The settlement agreement must be submitted to the Workers’ Compensation Appeals Board (WCAB) for approval. The WCAB will review the agreement to ensure that it is fair and complies with state laws. If an agreement cannot be made. Then the SIBTF case will go to a trial in front of a Worker’s Compensation judge at the Worker’s Compensation Board. All evidence will be introduced to the judge, and they will make a determination on the total disability percentage, and the dollar amount to be awarded to the injured worker.

8. Payment Method:

Depending on the terms of the settlement agreement, the worker may receive compensation through a structured settlement that would include bi, monthly payments, or, a lump-sum payment, or a combination of both. A structured settlement involves being paid bi-monthly while a lump sum provides a single, upfront payment.

9. Finalization of Settlement:

Once the WCAB approves the settlement agreement, the worker can expect to receive the agreed-upon compensation. It’s essential to ensure that all terms are met, and the settlement is executed as outlined in the agreement.

10. Ongoing Medical Treatment:

In some cases, the worker may continue to require medical treatment or rehabilitation. The settlement should account for these ongoing medical needs, and the worker should work closely with their attorney to address them. In summary, once an SIBTF case is settled. The insurance company is exonerated from paying any more money for medical treatment in the case. The case is considered final and closed, and the lump sum payment or the structured settlement are paid out. The injured worker is receiving the money that would go to any future medical treatment.

Can SIBTF Cases be Stipulated or Compromise and Released (C&R)?

Yes, SIBTF cases in California can be resolved through stipulated settlements or Compromise and Release (C&R) agreements, similar to other workers’ compensation cases. These settlement options provide flexibility and allow both parties to reach mutually agreeable terms. Whether a stipulated settlement or a C&R is pursued depends on various factors, including the preferences of the injured worker, based on the options, the injured worker and the SIBTF Attorney agree upon.

In a stipulated settlement, both parties agree to specific terms of the settlement, such as the amount and method of payment, as well as other conditions. The settlement agreement is then submitted to the WCAB for approval.

In a Compromise and Release agreement, the injured worker, their attorney, and the attorney representing the state agree on a lump-sum payment that represents the full value of the workers’ compensation benefits. Once approved by the WCAB, the injured worker receives the agreed-upon lump sum, which may include SIBTF benefits if applicable.

It’s important to note that the choice between a stipulated settlement and a C&R should be carefully considered, as it can significantly impact the injured worker’s financial situation and access to ongoing benefits. Applicant attorneys advise their clients whether to take monthly payments or one lump payment based on several factors. Some of these factors are age, current financial status, and the flexibility of the SIBTF, lawyer, to award, or if the case goes to trial, the flexibility of the judge, regarding the amount of the settlement to the injured worker.

In conclusion, the Subsequent Injury Benefits Trust Fund (SIBTF) in California provides crucial financial support to workers with pre-existing disabilities who sustain subsequent work-related injuries. Qualifying for SIBTF benefits involves meeting specific criteria, and the settlement process typically includes consultations with attorneys, medical evaluations, and negotiations. Settlements in SIBTF cases can be structured according to the preferences of the parties involved, whether through stipulated settlements or Compromise and Release agreements.

Where can I find the best workers compensation lawyer in Riverside County & other parts of CA to help with my SIBTF cas

Where can I find the best workers compensation lawyer in Riverside County & other parts of CA to help with my SIBTF case?

Seeking legal counsel with an experienced applicant attorney that specializes in SIBTF cases is essential to navigate the complexities of SIBTF cases and ensure that injured workers receive the compensation they deserve that is also structured in their best interest. 

To learn more about SIBTF you can visit the department of Worker’s Compensation at this link. Even better, you can reach out to California Workers Compensation Lawyers, APC and schedule a free consultation with an experienced work comp attorney in Riverside County and other parts of California directly. 

Our website also offers a wealth of information about the other aspects of workers compensation. Want to know whether representing yourself or hiring an attorney is the better course of action when it comes to obtaining compensation? Interested in an in-depth analysis of how state-funded insurance companies in California operate or learning more about the medical provider network controversies in the work comp system? We can answer all of these questions and more.

Continue browsing our website or reach out to us directly today!

How to Receive Compensation from Personal Injuries While On Vacation

Traveling, whether for business or pleasure, can come with a slew of stressors and extra responsibilities. And just as anywhere else, accidents and injuries can occur while on vacation, leaving families confused as to how to make a claim for compensation for an injury caused by someone’s negligence. Follow along as we share some of the most important personal injury facts and causes related to the most common types of claims.

Luckily, the process of seeking compensation for an injury sustained due to another’s actions or inability to act follows the same general themes and processes regardless of where in the US you might be. And personal injury is a general term used for a large variety of actionable offenses, including:

  • Auto accidents
  • Slip and falls
  • Wrongful deaths
  • Product injuries
  • Animal-related injuries (dog bites, etc.)
  • And much more

According to Trent Law, if you’re involved in a personal injury incident while on vacation, make sure you document and conserve all available evidence as quickly as possible. For example, in an auto accident, one of the most common types of personal injury incidents, there are several immediate steps you should take to ensure that evidence is preserved and to support your future claim for damages. These include:

  • Call 911 to report the vehicle accident
  • If you are injured, seek medical attention immediately. Often, the effects of an auto accident can take hours or even days to manifest. Seeking medical attention early and often is the best way to protect yourself from further harm.
  • Communicate your side of the story with responding officers. A detailed police report is one of the most important pieces of unbiased evidence in a personal injury claim. Ensuring the police officer on scene has a strong understanding of the events that transpired can help expedite your personal injury claim and ensure that all facts are readily available in the courtroom. 
  • Take photographs of everything available. Photographs are one of the primary forms of physical evidence in personal injury claims. Photos of injuries, damages to property, and similar evidence can be used to substantiate your claim in the future.
  • Make sure you have other supporting documentation from any accident investigation. For example, in a vehicle accident in which one driver was arrested for driving under the influence of drugs or alcohol, a subsequent arrest report may be a useful piece of evidence in proving the negligence of the at fault driver.
  • Contact your insurance company and inform them of the incident. However, avoid giving written or recorded statements to the insurance company. Consult an attorney to ensure that your claim is communicated effectively.

If you suffer an accident while on vacation, it’s important to consult with a locally licensed attorney to explore your options and discuss the process of making a claim. If you are involved in a personal injury accident on vacation in another state, the process of filing a claim can be more complex, primarily because some states may have different evidence or filing requirements. Additional factors may complicate your situation, such as a driver who is driving under the influence or being injured in a hit-and-run accident. 

A hit and run is when an individual causes a motor vehicle accident and flees the scene before communicating with you or the police. Engaging in a hit and run is a crime. If you are a victim of a hit and run on vacation, you may face more difficulty identifying the at-fault driver and completing a successful claim. As a result, it is imperative to immediately contact the police after being involved in an auto accident.

Being involved in a personal injury accident away from home can be stressful and anxiety-inducing. Personal injury claims can require the expertise of a licensed local attorney. When seeking legal remedies outside of your home state, you likely will need to contact an attorney from the area in which your incident occurred to satisfy licensing and jurisdictional requirements. For example, if you live in California but are injured in Texas, an attorney licensed to practice in your home state may not be credentialed to represent you in your claim in Texas. 

Generally speaking, when you file an action for a personal injury incident, it should be in the place or jurisdiction where the injury occurred. Rarely, plaintiffs may be able to file suit in the state in which they reside.

If you or a loved one has been involved in a personal injury incident while traveling on vacation or for business, consult an experienced personal injury attorney to ensure that your rights and interests are protected. The vast majority of personal injury attorneys work on a contingency fee basis, so you won’t be out of pocket for seeking the compensation you deserve. Instead, you’ll be able to focus on what’s most important: following your doctor’s instructions and seeking a speedy and effective recovery. Thanks to contingency fee agreements, personal injury victims can seek out legal counsel and ensure that their interests are protected. Attorneys who work on contingency fees are paid when you win your case in court, making it possible for many people to pursue personal injury claims.

What Medical Complication Expected Women Can Suffer In A Car Accident?

Severe car accidents involving expected mothers have more reasons to be concerned. Expected mothers not only worry about themselves but their babies as well. Such cases are very complicated as it is not easy to see when the unborn gets injured. Babies can sustain serious and life-threatening injuries even when their mother is okay.

Unfortunately, if an expected mother gets into a car accident, then she must know the following things to avoid any further damage.

Risk to Babies in the Car Accident

In an accident, an intense or sudden pressure exerted on the abdomen of the mother can be life-threatening to her and the child as well.

  • Placental Abruption: It is a serious complication. It causes the placenta to detach from the uterine wall, baby starves for oxygen and other nutrients that are needed for survival. Mothers may suffer miscarriage or go into premature delivery.
  • Uterine Rupture: When the muscular uterine wall tears and causes changes in the uterine contractions, abdominal pain, and potential bleeding then uterine rupture happens which possibly leads to the death of the child or mother, or both.
  • Miscarriage: Due to suffering trauma or impact a mother can miscarry during the accident.
  • Infection: In an accident foreign substances such as metal, fluids, plastic, and glass can enter the tissues and blood of the mother and unborn children. If this is left untreated then these things may cause sepsis which is a fetal blood infection.
  • Maternal Shock: Losing blood after the accident, the body of the expected mother struggles to pump the remaining blood to the vital organs. During this, the blood flow of the mother is directed away from the baby.
  • Fatal Injuries: Babies can sustain internal injuries during the accident like head trauma and/or internal bleeding.
  • Premature Birth: Delivery before the 37th week of pregnancy is premature birth because the child didn’t get enough time to fully develop. A car accident may result in premature birth which may cause possible medical complications in the child. A premature child may develop congenital disabilities that last for a lifetime. Some of these disabilities include hearing loss, lung problems, autism, heart defects, blindness, and intellectual disabilities.
  • Contrecoup and Coup Injuries: A contrecoup injury occurs when the head hits the stationary object. In contrast, the coup injury occurs when the object hits the head. Both injuries can occur in a car accident.

What Steps to Take After a Car Accident

Got into an accident? The first thing you need to do is remain calm and think clearly. Then you need to follow the below steps:

Get off the Road: For safety purposes, get off the road if an accident requires it unless your injuries made you unable to move.

Call Police: Let the police know you got into the car wreck and are pregnant. Listen to the officer carefully and answer the dispatcher of the question thoroughly.

Get Medical Help: Seek medical help immediately. If you feel okay, still seek medical care. Let the medical personnel examine you and your baby thoroughly.

For further claims, contact an experienced Victorville car accident lawyer who can guide you in the right direction. They will help you in investigating the claim and get you fair compensation.

The Cost of Addiction on your Workers’ Compensation Claim

Substance abuse to the point of developing a physical dependence is on the rise among workers. For an employer, this is a big problem.

Asides from lost man-hours, abuse of prescription medication raises the cost of workers’ compensation claims laid at the doorstep of employers. To make matters worse, as a result of the ruling in the case of Heffernan, employers can now also be held liable for fatalities and long-term health care costs arising from substance abuse and addiction of an employee.

Opioids are powerful and highly addictive painkillers, and they are also the most commonly abused substance among employees with addiction issues. A report from medical cost management provider, Healthesystems, indicates that abuse of opioids in workers’ compensation claims has gone up this decade along with the cost of such medications.

Mitchell International also pointed out that over $6 billion is spent yearly on prescription drugs for workers’ compensation-related cases. Since persons who use opioids for an extended period are likely to develop a tolerance to the drug, this means they will need higher doses to achieve the desired relief, leading to an increase of costs, an increased risk of developing an addiction, as well as a significantly higher claims cost.

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The Heffernan Case

This case involved J.D. Landscaping v. Workers’ Compensation Appeal Board (Heffernan) wherein James Heffernan hurt his back in 2002 while under the employment of J.D. Landscaping. He received treatment for five years and eventually died in 2007 of drug intoxication. The drug in this instance was fentanyl (a prescription narcotic painkiller).

Fentanyl patches were prescribed to Mr. Heffernan by his physician for managing the pain caused by his work-related injury. Mr. Heffernan’s daughter filed a work comp claim upon his death which the employer denied. But the Pennsylvania Workers’ Compensation Board and the courts determined that J.D. Landscaping was liable to pay death benefits under workers’ compensation.

The courts upheld this ruling even though it was established that Mr. Heffernan prior to his death had been barred from further access to fentanyl. But Mr. Heffernan was able to get a fentanyl prescription from a new doctor and two days later died of a fatal overdose.

Regardless of these facts, the employer was found liable. The court stated that an employer will be found liable to pay for death benefits as long as drugs or treatment are provided under workers’ compensation and are considered reasonable and necessary.

This raises the question of if an employer is liable for the death benefits of employees who abuse and overdose, even after they have been denied access to prescription medication? Where does the liability stop?

With this level of potential exposure, it is advised that employers become proactive by actively managing this risk from the onset in order to minimize the risk of a Heffernan-like incident.

Department Of Insurance Busted $25-Million WC Fraud

Department of Insurance detectives have arrested nine people in connection with a serious case of workers’ compensation fraud, which caused financial damage to more than 200 insurance carriers and self-insured employers.

A company called G&G Interpreting Services, run by siblings Francisco Javier Gomez, Jr. and Angela Rehmann, issued fraudulent bills for non-existent services of translating Spanish. The total worth of the fraud has been estimated at $24.9 million.

G&G Interpreting worked with clinics and was supposed to mediate between injured workers of Latino origin seeking medical care and the healthcare professionals for Personal Injury and After Work Injury’s. However, the investigation revealed that the majority of staff in the clinics were Spanish speakers, while in others over 10 doctors spoke Spanish fluently. Needless to say, services of an interpreter weren’t necessary.

The medical institutions with which G&G Interpreting allegedly worked are located throughout Southern California and include the counties of LA and San Diego, Santa Barbara, Riverside, Orange, San Bernardino and Ventura.

The detectives have established that the alleged services were delivered on about 83,000 occasions. What is interesting is that it turns out the interpreters worked over 12 hours a day, which is more than the clinics were open. There is also the fact that services worth $400,000 were delivered by an interpreter who was ubiquitously in state prison doing a sentence.

Insurance Commissioner Dave Jones said that there is a wide-spread misconception that defrauding the workers’ compensation system is a crime without a victim, because in the end everyone has to pay.

In 1991 the Department of Insurance founded Fraud Assessment Commission that established how much was to be funded through employer assessment for enforcement and prosecution costs. It was in that year that workers’ compensation fraud was given the status of felony.

In October 2015 Jones was given grants in the amount of almost $35 million to fight insurance fraud. The funds were allocated to the district attorney offices in 42 California counties. In this case, the investigation was run by Dept. of Insurance detectives and supported by Riverside and San Bernardino district attorney offices, as well as California Highway Patrol. The suspects will be prosecuted by Los Angeles County district attorney office.

If you need a wc lawyer Orange County, feel free to turn to Workers’ Compensation Attorney Group in Orange County for a no-cost, no-pressure case review. Our team of exceptionally experienced and both aggressive and ethical attorneys will listen to you carefully and provide you accurate information regarding your case. If you choose to hire our services, you should know we work on a contingent fee basis, so you only pay if we win your case.

Workers Compensation Press Updates

Can You Reopen Your Workers’ Compensation Claim?

An experienced workman’s comp attorney can very often help injured workers reopen claims after settlements. This possibility is especially beneficial for workers whose injury recurs or becomes worse and it is different from personal injury cases.

When can you reopen a workman’s compensation claim?

Certain circumstances and factors determine whether a worker is entitled to having a settled claim reopened. The first important question is how the claim was settled – was it through “Compromise and Release” or “Stipulation and Award”?

Compromise and Release is a type of settlement that is final and resolves the worker’s case completely: in the past, present and future. Unless the settlement was reached by means of fraud, Compromise and Release makes it impossible for the injured worker to reopen the case.

Stipulation and Award, together with trial, is a type of settlement that permits the worker to reopen the claim in the future if the need arises. The Labor Code sanctions reopened claims when some specific circumstances take place. Typically, there are four conditions that allow reopening a worker’s compensation claim:

  • when the injury has become worse or when it has come back
  • when new evidence has been discovered proving the settlement isn’t equitable and reopening the case would rectify an error of fact
  • when a fault in the law made the award unjust
  • when there was a clerical error

Injured workers with a settled claim who are thinking of reopening their cases should bear in mind that there is a time frame within which they can do this. This is called Statute of Limitations (SOL) and in workers’ compensation cases it is typically 5 years from the day of the injury.

Statute of Limitations in workers’ comp claims in Orange County

There are cases in which the old claim doesn’t have to be reopened, but the case can be filed. In the case of disability that has increased, the worker may have a cumulative claim, which is handled like a new claim. When this is so, the statute of limitations starts counting again from the “new” injury. Determining when SOL starts counting or recounting is quite complicated and can be handled only by an experienced worker’s comp attorney.

Because of the possibility to reopen the case in the future, workers are advised to think carefully before settling their claims through compromise and release. An experienced attorney can give you the best guidance on what you need to consider before accepting a settlement agreement, so that your interests and rights are best protected.

Workman’s comp attorney Orange County

If you or your close one are considering reopening your worker’s comp claim that has been settled, make sure you give Workers’ Compensation Attorney Group a call. Our attorneys have a vast knowledge and a huge experience in handling worker’s compensation cases. We are always ready to consult with you regarding your case free of charge and pressure to hire us. Remember that you only pay for our Orange County workers compensation attorneys when you recover your award, so feel free to call us right away!

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What To Do After A Work-Related Injury

The best thing you can do if you happen to get hurt on the job is ask experienced compensation attorneys for guidance. We understand you will probably not seek the services of a work comp lawyer prior to getting injured, so this article will outline the important steps to be taken right after you have been injured in the workplace.

Report your injury to your manager

The most important thing you should do if and when you get hurt while performing job duties is let your manager know about your injury. If there were any witnesses, remember them and make sure you have their contact details. If there is any evidence, it should be collected. If possible, the accident site should be photographed. However, keep in mind there may be some security or confidentiality restrictions preventing you from taking photographs.

After your injury has been reported to your superiors, you should be provided with a form for making workers’ compensation claims in California, which is known as DWC-1. If your superior fails to give you the form, remember that it’s your right to ask for it.

The claim form is filled out by both parties, meaning you and your employer. When the form is fully filled out, request to be given one copy of it.

Filling out the workers’ compensation claim

When you are writing the claim, make a point of including all the body parts that were possibly injured in the claim. To illustrate this, we can use an example – if an object should fall on your shoulder, but it is your back that hurts, you should list both the shoulder and the back as injured body parts.

It will be possible to amend the claim later, but when you initially fill it out try not to leave out anything. That doesn’t mean you should lie or misstate anything, but it’s better to include more rather than less. Finally, you will be examined by a doctor to determine the scope and severity of your injuries.

Don’t be afraid to assert your rights

It’s disappointing how many workers decide to keep silent about getting hurt on the job because they are afraid of losing their employment. The reality is very few employees get terminated after reporting a personal injurychemical exposure injury or any other work-related injury. The workers’ compensation law protects employees from that and it’s illegal to terminate an employee because they have sustained an injury in the workplace and reported it. Employers are aware of the law and don’t wish to get involved in a costly lawsuit.

Do your best to report the injury in the shortest period possible, because that will drastically improve the chances of actually recovering the compensation you deserve.

Have an experienced workman’s comp lawyer fight for your rights

Having professional legal guidance is extremely valuable when you are asserting your employee rights in a compensation claim. If you are looking for a competent Orange County workers compensation attorney, make sure you give Workers’ Compensation Attorney Group a call. Our expert compensation attorneys are always ready and willing to review your case free of charge and without putting you under pressure to hire us. Just bear in mind that our aggressive, experienced and ethical attorneys work for a contingency fee, which means you only pay for our services when you recover your compensation. Do not hesitate to call us – we are always here for you!

Workers Compensation Press Updates

Stipulation & Award Closure of Workman’s Compensation Claim in Orange County

There are a number of ways in which a workman’s compensation claim can close. The most common way is through Compromise and Release (C&R) in which the applicant gives up their rights to a lump-sum compensation. Once the judge approves the settlement by issuing an order, the claim is closed forever. This is a very popular way of ending claims because it helps parties avoid inherent risks of pursuing the claim in court (when both parties risk the outcome of an unsatisfactory compensation).

Another way a claim can be ended is through Stipulation and Award.

The basics of Stipulation and Award in Orange County CA

This closure is less popular than Compromise and Release. There is no lump-sum compensation paid out to the applicant, but a level of disability is stipulated and future medical care provisions are secured for the injured employee. The value of this compensation is usually smaller than with C&R because the medical part of the settlement is left open. Financial compensation is provided on a weekly basis until the set amount is exhausted. This compensation is called permanent disability money provided for injuries incurred in the workplace as a result of hazardous exposure. The disability, or physical impairment, is assessed through American Medical Association Guides of Permanent Impairment. Future medical care (FMC) is provided, but it must be reviewed and approved by the insurance provider.

Downsides of Stipulation and Award

When a workman’s compensation case is concluded in this way, it is unfavorable for the claimant since the compensation is nowhere near as high as with Compromise and Release and it’s stretched over a long period of time (usually years or, less usually, decades).

Moreover, it’s disadvantageous for the injured employee that the medical treatment and care are and will be controlled by the insurance adjuster. Insurance providers commonly try to postpone or block medical procedures even when they’re doctor-recommended. California insurance carriers for workers’ compensation are infamous for turning down medical treatment procedures, and this is much more wide-spread than with the private health sector.

Upsides of Stipulation and Award

The fact that future medical care (FMC) is open is a good thing for the worker. This is especially true in the case of chronic conditions, when FMC is the only financially feasible option within the system, even though the care will remain in the control of the adjuster.

Another hidden advantage is the possibility of reopening the case if another related disability appears. The SOL (time limit) for this is 5 years since the date of the initial injury. If there are conditions or consequences that weren’t foreseen at the time of the settlement, there’s a chance to get an amount bigger than the permanent benefit and a wider medical coverage for the new or further impairments caused by the original injury.

A third upside is the opportunity to get a bigger amount of C&R if the claim is reopened due to further consequent impairments. This wouldn’t be possible if the case had been originally closed through C&R.

Get an Expert Attorney to Handle Your Workman’s Comp Claim In Orange County CA

If you or someone dear to you has incurred injuries like a head or brain injury on the job in Orange County , don’t hesitate to contact an experienced, aggressive and ethical workers compensation lawyer at Workers’ Compensation Attorney Group in Orange County. Our lawyers are experts with an invaluable experience in leading workman’s compensation claims. Contact us right away to get a free case review with no pressure or obligation to retain our services. If you do choose to hire us, you don’t need to worry about exorbitant legal fees – you pay only if we win! You have nothing to lose, but you will certainly gain valuable time and legal guidance.

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Workers Compensation Press Updates

Termination After A Workers’ Compensation Claim


If your employer terminates you following your compensation claim, you should immediately seek help from an experienced attorney in your area. It is against the law to dismiss a worker after he or she has sustained an injury in the workplace and filed a compensation claim thereafter.

That is, an employer cannot terminate an employee on the grounds of their work-related injury or because the employee asked for compensation. While the claim is being resolved or pending, the employee can be terminated or made redundant, but the termination cannot be due to the fact that the worker has sustained an injury and filed a claim or because the injured worker needs to perform a reduced scope of duties.

Being afraid of termination after filing a compensation claim

Many workers who sustain injuries or cumulative trauma in the workplace are afraid they are going to lose their employment if they file a claim or report it to the employer. This makes them apprehensive and anxious. It often happens that the injured worker tolerates the harmful injury and foregoes proper medical treatment, all the while performing their work duties as if nothing has happened.

Unfortunately, when an injury is neglected and when the injured person is deprived of recovery, the detrimental effect of the injury usually worsens until it prevents the worker from doing their job as they should. The paradox is that these circumstances might make losing the job more probable, which is exactly what the worker wanted to avoid by not reporting the injury.

To make things worse, when the injury is not reported in a timely manner, the prospect of filing a claim and getting compensation is significantly diminished. It will be doubtful and difficult to prove whether the injury is related to the performance of work duties at all. It can appear that the employee was injured outside the workplace and is now trying to frame their employer for it.

What can be done after termination following a claim

The most important thing you should do is report your work-related injury to your employer in the shortest period possible, even when you are afraid you might be terminated. It is not at all common that an employee is terminated because of having filed a compensation claim as that can directly lead to a variety of lawsuits.

If the worker reports the injury, files a compensation claim and asks for benefits and then experiences termination or discrimination in the workplace, the employer will face harsh penalties that can be demanded in court. It is also illegal to terminate a worker for having a disability, and remedies for that are provided in the Fair Employment Housing Act.

Have a workman compensation lawyer protect your rights

You shouldn’t be discouraged from claiming a compensation for benefits because you are afraid of termination or discrimination. You have the right to ask for benefits if you incurred an injury while doing your job. It’s extremely rare for employees to get fired because of the compensation claim, because

employers know such a move would entail more lawsuits. The whole idea behind the workers’ compensation system is to benefit both sides – ensure the medical help and benefits for the employee are cost-effective and that the worker returns to the workplace in good health and ready to work.

If you live or work in Orange County and sustain a work-related injury, don’t hesitate to contact Workers’ Compensation Attorney Group in Orange County. Our workman compensation lawyers are experienced, aggressive and ethical and they will only charge you if you recover the compensation. Feel free to call us right away and talk one on one with one of our expert lawyers. Have a free case review with no pressure to hire us. You can only gain if you call us!

Workers Compensation Press Updates
Stipulation&Award in Workman’s Comp – Orange County