Getting injured on the job is far from ideal and ends up causing a snowball of effects that can long for an extended period. Whether it be sustained injuries, expenses, or legal proceedings, no one wants to go through the workers’ compensation process, let alone deal with any issues it may bring to the surface, including the employer.
As an employer, though, you have the right to know how to handle an injury claim filed by an employee injured in the workplace. The Van Nuys workers’ compensation coverage issues & arbitration attorney at Sacks Law Group, APC, can answer all of your workers’ compensation arbitration questions you have as an employer.
Workers’ compensation covers almost all work-related injuries and illnesses. Doctor’s visits, hospital stays, surgeries, or other medical procedures all fall under workers’ compensation. Some states provide additional coverage for other kinds of treatments, but there are often limits. It is the responsibility of the insurance agencies to authorize or approve the treatment that a medical professional has recommended.
Medical benefits become available once the employer’s insurance company accepts the claim. Insurance companies will pay medical providers directly, so the injured employee shouldn’t get billed for doctor visits.
Medical treatment might be covered, during which the insurance company is deciding if they should accept or deny the claim. Some states require insurance companies to pay up to $10,000 in medical expenses while investigating the case simultaneously. Should the insurer deny the claim, the victim will not be held accountable to pay for any medical bills while the claim is pending.
Arbitration is a popular method of dispute resolution used in the business world because it occurs outside of the court system. It allows the parties to reach an agreement on any topic, in this case, workers’ compensation benefits, with the assistance of their attorneys and a third-party arbitrator.
During the arbitration, each party will have the opportunity to present their case, including testimony and evidence. If necessary, the arbitrator will schedule additional meetings with one or both parties to submit additional evidence.
Once both parties have pleaded their case, the arbitrator will review the testimony and evidence presented in order to make a decision. The decision made by the arbitrator is binding, which means that a lawsuit can be filed if either party fails to abide by the decision. It can be difficult to appeal a decision made during arbitration, but not impossible.
As an employer, you might legitimately want your employees to recover the workers’ compensation benefits for which they are eligible if they are harmed on the job or if they develop medical conditions as a result of exposure to hazards in the workplace.
You might also understand that some employees who file claims for workers’ compensation benefits are not genuinely entitled to receive them.
A worker might not be eligible for workers’ compensation benefits if they were injured:
There might be times when you are justified in denying an employee’s workers’ compensation claim. Doing so can prevent an employee from unfairly taking advantage of a system.
It can also be a wise financial decision. Typically, the more often employees successfully file workers’ compensation claims and recover benefits, the more your insurance premiums will rise. While you shouldn’t deny a valid claim simply to save money, you also shouldn’t allow a claim to proceed if you have good reason to believe the employee who filed it does not actually deserve workers’ compensation benefits.
The case may go to arbitration if you deny a claim and an employee disputes your decision. When this happens, strongly consider enlisting the help of experienced professionals. The team at our Van Nuys workers’ compensation coverage issues and arbitration law firm can help you by:
Generally, a qualified Van Nuys workers’ compensation coverage issues lawyer can also assist you in various ways if there are ever circumstances in which it appears you may not be offering sufficient coverage to your employees.
In California, virtually every single employer must purchase workers’ compensation insurance. If you do not purchase workers’ compensation insurance and an employee is injured on the job, you may be the target of a claim or lawsuit. This can have serious financial repercussions for your business. Additionally, some employers may face criminal penalties for not having proper workers’ compensation coverage.
This does not need to happen to you. At our Van Nuys workers’ compensation coverage issues firm, we offer such services as:
Coverage issues can threaten your livelihood and your company. We will work hard to protect you in these circumstances.
At Sacks Law Group, APC, we know that your employees can refuse to file a claim for a workplace injury and even refuse to get medically examined. Our team of workers’ compensation attorneys is here to answer your questions about coverage issues and arbitration so you are prepared if and when an employee is injured on the job. Do not settle for less than what you deserve. Contact the Van Nuys workers’ compensation coverage issues & arbitration attorney today to protect your company. Call our office at 310-216-7778 to schedule a consultation.
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