When it comes to injured workers, California has certain laws that provide rights and benefits to those who have suffered a specific injury or cumulative injury on the job. Alice A. Strömbom is a Sacramento workers’ compensation attorney that is dedicated to helping you utilize your rights to receive the compensation that you are entitled to. You have a right to a number of benefits, and she will work tirelessly to help you achieve this goal.
The three major considerations when a work-related injury occurs
- Immediate medical care
- Temporary monetary benefits
- Full Assessment to determine permanent benefits
An insurance company could deny a request from their own network of physicians for medical treatment. It is not uncommon for an insurance company to avoid responsibility when it comes to authorizing a treatment, even if it’s been prescribed by a physician. They do this by Modifying, Delaying or even denying the request altogether. Insurance companies will use a complicated, time-limit maze know as “utilization review” Process. In order to determine whether or not the utilization review was legally valid, and if “independent medical review” is available, will often require serious legal analysis.
A Medical Provider Network (MPN) is a group of physicians hand-picked by an insurance company to provide medical treatment. It may require a legal analysis, to determine whether or not an injured worker can use a physician for medical treatment outside of the MPN.
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Three Factors After A Workplace Injury
First, an injured worker’s rights include immediate care by a qualified physician (or team of physicians) who can evaluate and treat all consequences of an injury – not just the injuries an employer is willing to recognize. While the Claim is under investigation, insurance companies will often withhold medical treatment, even though the law requires payment of medical treatment up to $10,000 while the investigation is taking place. It is even more often that an insurance company will only allow treatment for part of the injuries and ignore the rest. However, the law requires that all of the work-related injuries be treated by the employer and their insurance company.
Second, When you are forced to miss work due to a work-related injury or condition, you have the right to certain tempory wage replacement benefits (Total Temporary or Partial Temporary Disability benefits). These benefits are to be paid to you promptly by the employer’s insurance company. Insurance companies will often use physicians that will prematurely send injured workers back to work before they are able to return, or to the same duties that caused the injury in the first place. Also, TTd and TPD are often paid out at a lower or even wrong rate than what is actually legally owed.
Third, An injured worker has the right to have an assessment of all of the activities that have been permanently limited as a result of the injury or condition. This assessment will happen in the conclusion of the active treatment process. The injured worker will then be awarded permanent disability benefits based on the extent of those limitations. In the case of a career-ending injury, a vocation expert may be necessary to for the assistant.