As an employer, you no doubt respect and appreciate your employees and want them to have any and all benefits to which they are entitled, including benefits under your company’s workers compensation insurance coverage. Workers’ compensation costs are a burden on your bottom line, but they are also a necessary part of doing business—and one that is required by law in the state of California. However, as an employer, if it is your belief that your employee’s injuries were not your fault, then you have a right to defend yourself against the employee’s claim. A workers compensation defense attorney can help.
Defense Against Workers Compensation Claims
There are a number of reasons that an injured worker’s claim may be indefensible. Some of the most common among them:
- The employee filed the claim after the statute of limitations ran out. In other than a few very narrow exceptions, California workers compensation claimants have just one year from the date of work-related injuries or illnesses to submit their claims. Workers may have slightly more time if their claims center around an occupational disease such as toxic or chemical exposure.
- The employee was injured, but not on the job. In order for employees to collect benefits from workers’ compensation, the injury in question must be job-related. If an employee sustains an injury off the clock or not during the course of job-related activities, then the claim is invalid.
- Willful negligence caused the employee’s injury. Employers are required by law to provide workers compensation injury, but employees are duty-bound to avoid reckless behavior, horseplay, and other conduct that might result in injury. This includes alcohol/drug intoxication.
- The employee’s injury was intentional. Most workers’ compensation claims are valid, but there is always an exception to this rule. It is not unheard of for claimants to undergo self-inflicted injuries in order to collect benefits.
- An idiopathic medical problem caused the employee’s injury. Conditions such as heart attack, seizure, and stroke occur without notice, and sometimes they happen in the workplace, resulting in or exacerbating workplace injuries. However, if there is evidence that the employee’s medical problem was not caused by the job itself, then the injury resulting from the condition cannot be classified as a work-related injury.
The role that worker’s compensation insurance plays in the California workplace cannot be overstated. Not only is it important to the employee, but it also protects the employer by providing compensation for injured employees that does not come straight out of the employer’s pocket. Moreover, employers who do not provide this valuable insurance to their workers may face substantial civil penalties while opening themselves up to potential liability if a worker sustains a job-related injury and files a claim for damages. Still, invalid or fraud-based worker’s comp claims drive up worker’s compensation insurance costs, and nobody benefits from that.
How a Van Nuys Workers’ Compensation Defense Attorney Helps
If you believe that an employee who has filed a claim to recover workers’ compensation benefits is not actually eligible to receive them, you might choose to deny their claim. While you may be a responsible employer who genuinely wants your employees to receive compensation for their medical bills and lost wages when they are injured on the job, you might also appreciate the importance of preventing workers from taking advantage of the system or even committing workers’ compensation fraud.
It’s possible the employee who filed a claim will dispute your choice to deny it. If this occurs, it is wise to protect yourself by enlisting the help of professionals who have handled cases like yours in the past. The experts at our Van Nuys workers’ compensation defense law firm can assist you by:
Investigating the case
Again, in California, an employee is only eligible to recover workers’ compensation benefits if they were legitimately injured when operating in the scope of their employment or if they developed a medical condition as a result of hazardous work conditions. They are not eligible to recover compensation if they were “off the clock,” intoxicated, engaging in horseplay, or intentionally trying to harm themselves when they were injured.
You likely chose to deny an employee’s workers’ compensation claim because you were able to determine that the circumstances in which they were injured or developed a medical condition did not grant them the right under California law to collect workers’ compensation benefits. If the employee takes legal action after you have denied their claim, it may be necessary to investigate their accident to gather evidence proving that it was not work-related.
This is not a task you need to burden yourself with. A qualified Van Nuys workers’ compensation defense lawyer has the resources and expertise needed to thoroughly investigate a claim on your behalf. We will help you present evidence showing that you had a justifiable reason to deny an employee’s workers’ compensation claim if said employee argues that their claim should not have been denied.
Handling the appeals process
In our state, when an employee is unhappy with an employer’s decision to deny a workers’ compensation claim, the employee can file an appeal with the Workers’ Compensation Appeals Board (WCAB). The WCAB then has 60 days to accept the appeal or reject it. However, even if the WCAB denies an appeal, an employee can still further appeal the decision to the state appellate court for a “writ of review.” They may even bring the case all the way to the California Supreme Court, although this is a rare occurrence. Be aware, that you also have the option of appealing a decision if the WCAB sides with an employee.
As an employer, you are likely already busy handling numerous responsibilities. Instead of attempting to navigate the appeals process on your own, hire a Van Nuys workers’ compensation defense attorney. We will guide you through every step of the process so that you can focus on other priorities.
Legal Help for Employers
When it comes to defending your company against erroneous or even fraudulent workers compensation claims, reach out to an experienced Van Nuys workers compensation attorney with Sacks Law Group, APC, right away. You can contact us for a consultation of your case by clicking here or calling 310-216-7778.
310-216-7778
