Home Blogs

Does my employer have to provide medical treatment if I get hurt at work?

Joseph Pluta — Fri, 01 Nov 2024 10:24:21 +0000

If you are hurt at work, your employer must provide you with all treatment reasonably necessary to cure or relieve from the effects of your work injury. Your employer is required to provide this medical treatment at no cost to you. To qualify for medical treatment, your injury must arise out of your employment and occur in the course of your employment. That’s a legal way of saying that your injury must be linked to your job. If you aren’t sure whether your injury is sufficiently linked to your job, you should consult a workers compensation attorney as this is a complicated area of the law where small facts can make a big difference. You can also get legal help from a personal injury lawyer.

How do I get medical treatment for my work injury?

In order to trigger your employer’s obligation to provide medical treatment you must report your injury to your supervisor as soon as possible. Once your employer has knowledge of your injury (either through your report or any other means) they must provide you with a claim form and notify you of your right to workers’ compensation benefits, including medical treatment. In accordance to workers compensation law, filling out the claim form starts your workers’ compensation claim. Your employer’s workers’ compensation insurance company then has 90 days to either accept or deny your claim. During the 90 day period while the insurance company determines whether or not to accept your claim, they must provide you with medical treatment up to a $10,000 cap.

Can I go to any Doctor for my Medical Treatment?

Generally speaking, you do not get to pick any Doctor you want. These days, most workers compensation insurance companies have a Medical Provider Network (MPN) with several doctors who practice in various specialties. Your first trip to the doctor will always be to the company doctor who is a member of the MPN. You can avoid treating in the MPN if you predesignate your primary treating physician (PTP) and that physician accepts you as a patient. Your HR department should give you the pre-designation form when you start your employment. You can also find it here: https://www.dir.ca.gov/dwc/FORMS/DWCForm_9783.pdf It is always to your advantage to treat with the best PTP available.

What kind of medical treatment do I get?

Your medical treatment is limited to treatment that is reasonably necessary to cure or relieve the effects of an industrial injury. Which begs the question: what is reasonably necessary? In California, the Medical Treatment Utilization Schedule or MTUS provides guidance. Essentially, the MTUS attempts to list all medical issues a person might encounter and then list appropriate treatment for each condition. Your PTP will diagnose your condition and then request authorization for treatment which will be reviewed by another doctor in the Utilization Review process.

DISCLAIMER: This website contains general information and is only intended for educational purposes. Because laws are constantly changing, the information is not guaranteed to be correct and/or current. Nothing contained on this website is intended to be a substitute for legal advice and does not constitute legal advice. Reading this website does not create, and should not be construed to create, an attorney-client relationship between the Law Office of Joseph Pluta and the reader. Nothing within this website should be considered as providing legal advice or a legal opinion. Sending an E-Mail to this website, or interacting with this website in any other way, does not create an attorney-client relationship.

Consult With Lawyer Now

The post Does my employer have to provide medical treatment if I get hurt at work? appeared first on Joepluta.

Advocating for Injured Workers: Introducing Bakersfield’s Workers’ Compensation Attorney

Joseph Pluta — Mon, 11 Dec 2023 10:15:33 +0000

Bakersfield, CA – July 11, 2023 – Bakersfield welcomes a dedicated Workers’ Compensation Attorney committed to providing legal support for injured workers. With expertise in workers’ comp personal injury, wrongful death, and social security disability cases, Joseph Pluta and his firm are prepared to offer exceptional services to clients in Bakersfield and surrounding areas.

Joseph Pluta Attorney at Law brings extensive experience and in-depth knowledge of workers’ compensation laws to their practice. Specializing in personal injury claims arising from workplace accidents, wrongful death cases, and social security disability claims, they are committed to assisting injured workers navigate the legal complexities of their situations.

At Joseph Pluta Attorney at Law, the primary goal is to ensure that every client receives fair treatment and a just resolution. Recognizing the challenges faced by injured workers and their families, Joseph Pluta provides personalized attention, aiming to achieve favorable outcomes while alleviating the burdens faced during difficult times.

This Workers’ Compensation Attorney is dedicated to advocating for their client’s rights. Through diligent negotiation and representation, they work to secure appropriate compensation for their clients. Joseph Pluta and his firm have a reputation for successfully navigating complex legal situations and achieving favorable results. Injured workers can rely on their support and expertise to protect their rights and well-being.

In addition to their specialization in workers’ compensation law, this attorney possesses experience in personal injury and wrongful death cases. Whether the result of workplace accidents, negligence, or product liability, they have the skills to build strong cases that hold responsible parties accountable and seek fair compensation for victims and their families.

Joseph Pluta Attorney at Law also offers guidance and representation in social security disability cases. Understanding the challenges faced by individuals seeking disability benefits, they navigate the complex bureaucracy to ensure their clients receive the financial support they deserve.

For individuals who have suffered a workplace injury, experienced the loss of a family member due to negligence, or require assistance with a social security claim, the Workers’ Compensation Attorney is ready to provide assistance. With a dedication to providing exceptional legal representation and unwavering support, they strive to advocate for justice on behalf of their clients.

For all inquiries, please contact:
https://www.joepluta.net/contact-us/
Joseph Pluta
Joseph Pluta Attorney at Law
408 18th Street Bakersfield, CA 93301
(661) 395-1031
info@localhost

The post Advocating for Injured Workers: Introducing Bakersfield’s Workers’ Compensation Attorney appeared first on Joepluta.

Empowering Personal Injury Victims: Introducing Bakersfield’s Personal Injury Attorney

Joseph Pluta — Mon, 11 Dec 2023 10:14:03 +0000

Bakersfield, CA – July 11, 2023 – Bakersfield welcomes a dedicated Personal Injury Attorney committed to providing legal support for victims of personal injury incidents. With expertise in personal injury claims, including workplace accidents, wrongful death, and more, Joseph Pluta Attorney At Law are prepared to offer exceptional services to clients in Bakersfield and surrounding areas.

Joseph Pluta Attorney At Law brings a wealth of experience and in-depth knowledge of personal injury laws to their practice. They specialize in representing individuals who have suffered harm due to workplace accidents, negligence, product liability, and other unfortunate incidents. The attorney is passionate about empowering personal injury victims and helping them seek rightful compensation for their losses.

At Joseph Pluta Attorney At Law, we focus on providing compassionate and personalized attention to each client. They understand the physical, emotional, and financial challenges faced by personal injury victims and their families. With a commitment to our clients’ well-being,Joseph Pluta Attorney At Law strives to achieve favorable outcomes, alleviate their burdens, and guide them through the legal process.

This Personal Injury Attorney excels in building strong cases and holding responsible parties accountable. Whether it is negotiating with insurance companies, advocating in settlement discussions, or representing clients in court, they tirelessly fight for the rights of personal injury victims. Their expertise and dedication have earned them a reputation for successfully navigating complex legal situations and achieving favorable results.

In addition to their specialization in personal injury law, the attorney possesses extensive knowledge in wrongful death cases. They understand the devastating impact that the loss of a loved one due to negligence or accidents can have on families. With empathy and professionalism, the attorney supports grieving families, seeking justice and compensation on their behalf.

For individuals who have experienced personal injuries, suffered the loss of a family member, or need legal assistance in personal injury matters, the Personal Injury Attorney is ready to provide dedicated support. With a commitment to providing exceptional legal representation and unwavering advocacy, they strive to empower personal injury victims and help them rebuild their lives.

For all inquiries, please contact:
https://www.joepluta.net/contact-us/
Joseph Pluta
Joseph Pluta Attorney at Law
408 18th Street Bakersfield, CA 93301
(661) 395-1031
info@localhost

The post Empowering Personal Injury Victims: Introducing Bakersfield’s Personal Injury Attorney appeared first on Joepluta.

Seeking Justice for Loss: Introducing Bakersfield’s Wrongful Death Attorney

Joseph Pluta — Mon, 11 Dec 2023 09:51:35 +0000

Bakersfield, CA – July 11, 2023 – Bakersfield welcomes a compassionate Wrongful Death Attorney dedicated to providing legal support to families who have suffered the loss of a loved one due to negligence or wrongful actions. With expertise in wrongful death cases, Joseph Pluta Attorney At Law are committed to offering exceptional services to clients in Bakersfield and surrounding areas.

The Wrongful Death Attorney brings extensive experience and specialized knowledge in handling wrongful death claims. They understand the devastating impact that the loss of a loved one can have on families, both emotionally and financially. With empathy and determination, they strive to seek justice for grieving families and hold responsible parties accountable.

At Joseph Pluta Attorney At Law, the attorneys provide personalized attention and compassionate support to each family. They understand the unique challenges faced during such difficult times and work diligently to alleviate the burdens families may encounter. By navigating the legal process on their clients’ behalf, Joseph Pluta Attorney At Law aims to achieve a favorable resolution and secure the compensation that families deserve.

This Wrongful Death Attorney is dedicated to fighting for justice. They have a proven track record of successfully representing clients in wrongful death cases, whether they result from workplace accidents, medical malpractice, automobile collisions, or other tragic incidents. With their expertise and unwavering commitment, they strive to provide closure and support to families in their pursuit of justice.

In addition to their specialization in wrongful death cases, the attorney possesses comprehensive knowledge in personal injury law. They understand the complexities of personal injury claims and how they can be intertwined with wrongful death cases. This expertise allows them to provide comprehensive legal representation and support to families throughout the legal process.

For families who have experienced the devastating loss of a loved one due to negligence or wrongful actions, the Wrongful Death Attorney is here to offer compassionate guidance and dedicated legal assistance. With a commitment to providing exceptional representation and striving for justice, they aim to help families find solace and seek accountability for their tragic loss.

For all inquiries, please contact:
https://www.joepluta.net/contact-us/
Joseph Pluta
Joseph Pluta Attorney at Law
408 18th Street Bakersfield, CA 93301
(661) 395-1031
info@localhost

The post Seeking Justice for Loss: Introducing Bakersfield’s Wrongful Death Attorney appeared first on Joepluta.

What’s the deal with the Voucher and how do I get it?

Joseph Pluta — Fri, 03 Mar 2023 10:30:55 +0000

What exactly is this Voucher I keep hearing about?

If you were injured in the course of your employment on or after January 1st, 2013 you may be eligible for supplemental job displacement benefits (SJDB). If you were injured before January 1st, 2013, you may still qualify for SJDB but there are several differences from the SJDB discussed in this article. In those cases, it’s a good idea to consult a knowledgeable workers compensation attorney. Better known as a voucher, SJDB have changed over the years so your date of injury determines what kind of SJDB you may be entitled to.

Do I qualify for the voucher?

workers comp voucherUnder current law, to qualify for a voucher you must:

1: suffer a work injury that causes permanent disability and
2: receive no offer of alternate of modified duty with your employer.

Once your disability claims administrator receives notice of your permanent disability they have 60 days to send you an offer of alternate or modified duty. If they fail to send you this notice then you are eligible for the voucher. Any offer of alternate or modified duty must be an offer for work that lasts at least 12 months to be a qualifying offer.

What is alternate or modified duty?

You will often hear the term alternate or modified duty used interchangeably. It is important to know that the term refers to two different kinds of work. When you are offered modified duty, you return to your old position but your employer accommodates any restrictions you have as a result of any permanent partial disability you have. For example, you may have permanent restrictions of no sitting for more than two hours at a time. Modified duty would account for this restriction and allow you to continue working in that position. Alternate duty typically refers to another position with your employer which pays at least 85% of your prior wages.

How do I get the Voucher?

Once the 60 day period to offer you alternate or modified duty expires, your claims administrator has 20 days to send you the voucher. The voucher will expire either five years after your date of injury or two years after the voucher was issued, whichever is later.

Return to work supplemental program

The state of California offers an additional, one-time supplement of $5,000 if you were injured on or after January 1, 2013 and you have received a voucher. You must apply for the return to work supplement within one year of receiving your voucher. You can apply for the supplement here.
Consult With Lawyer Now

The post What’s the deal with the Voucher and how do I get it? appeared first on Joepluta.

My Boss is Telling Me That I’m an Independent Contractor After an Injury At Work.

Joseph Pluta — Fri, 03 Mar 2023 10:28:52 +0000

Many people who are injured at work are told by their employers that they are not employees but are independent contractors. This distinction is important because, under California law, employees are entitled to workers’ compensation benefits; independent contractors are not. Thus, if you are an independent contractor who is hurt on the job, you cannot sue your employer for workers compensation benefits. Fortunately for injured workers, whether or not you are considered an employee or an independent contractor is decided by a workers’ compensation judge and not the employer.

What factors will a Workers’ Compensation Judge look at to decide if you’re an employee or an independent contractor

Currently, the 1989 case of S. G. Borello & Sons, Inc. v Dept. of Industrial Relations (48 Cal.3d 341 1989) provides several factors that workers’ compensation judges will examine to decide an employee verses independent contractor dispute. In determining whether a worker is an employee or an independent contractor, the most important factor a judge will look at is the right to control, whether or not the employer exercises that right. To think about it another way, in an employer-employee relationship, the employer is interested in and controls the means, manner and mode by which the work is performed. On the other hand, the principal who contracts an independent contractor is only concerned with the results of the work and not the manner in which the results were obtained.

Judges will also look whether an employment relationship can be terminated or if the relationship can only be terminated upon completion of a contract. Judges will look at whether or not the injured worker is performing services which he performs in his own trade or business, the degree of skill involved in that service, the kind of occupation, who supplies the tools, who supplies the location where the work is completed, the length of time for the work to be completed, the method of payment for the services and whether or not the parties believe they are creating an employer-employee relationship.

Putting it all together

If you’re still confused how all those factors apply to you, you’re in good company. The law presumes there is an employer-employee relationship where a person provides a service for another. It is the responsibility of the employer to prove that you are an independent contractor and judges are going to look beyond a simple label of independent contractor. Here, I like to think of it as the tie goes to the runner and in workers compensation, the employee is the runner. If you are hurt and your boss is telling you that you are not eligible for workers’ compensation benefits because you are an independent contractor and not an employee you should consult an experienced workers’ compensation attorney even if you are paid with IRS Form 1099 and not a W-2.

Stay Tuned

While the above is the current state of the law regarding employee vs independent contractor in workers’ compensation law, a recent wage order case in 2018 may completely change the playing field if its reasoning is extended to workers’ compensation.

Consult With Lawyer Now

The post My Boss is Telling Me That I’m an Independent Contractor After an Injury At Work. appeared first on Joepluta.

Why is the insurance company denying medical treatment for my workplace injury?

Joseph Pluta — Fri, 03 Mar 2023 10:26:24 +0000

Why can’t I get the medical treatment I need? This is a question that workers compensation lawyers frequently hear from many frustrated people. In the workers’ compensation world, the medical treatment that your employer is required to provide is limited by the Medical Treatment Utilization Schedule (MTUS). The schedule was sold as a way to streamline access to medical treatment with promises of evidence-based, peer-reviewed nationally recognized standards of care. On its face, it sounds exactly like something you would want applied to you. In practice, it makes getting the medical treatment you need more difficult. I like to think of it like a marketing tool from a cable company where you can get speeds up to a certain limit but everyone knows you’re not getting those speeds regularly.

How do I get treatment in the workers’ compensation system?

The way medical treatment works in the workers’ compensation system is you see your primary treating physician (PTP) who diagnoses your condition and decides on a course of treatment. But, just because your doctor determines that you need a treatment does not mean that you get that treatment. Your Doctor must submit a request for authorization (RFA) to the adjuster handling your case. The adjuster can, but rarely does approve treatment. Typically, the adjuster submits the request for authorization to Utilization Review or UR.

What is Utilization Review?

What that means is a doctor who you never see and who never examines you reads the RFA and a portion of your medical file and decides whether that treatment is necessary. If the UR doctor approves your treatment you get it; if he doesn’t you don’t get that treatment. If your treatment is denied at UR, you can appeal the denial through the Independent Medical Review process or IMR. In IMR, a second doctor you never see reviews the RFA, the UR denial and your file and either upholds or overrules the UR denial. If IMR upholds the denial, you don’t get that treatment. To top it off, you must wait another year before your doctor can resubmit the request unless your condition materially changes.

If that process sounds crazy to you, it’s because it is crazy. It’s also an excellent way to save insurance companies money. The hoops that an injured worker has to jump through to get medical treatment under the Workers’ Compensation system lead many people sell back their right to medical treatment at the end of their case through a compromise and release. (NOTE: Compromise and Release will be a future blog topic) Time and time again I hear clients talk about their frustration with the medical treatment and many express the desire to get out of the workers’ compensation system for good and (hopefully) never have to think about it again.

If you have questions about medical treatment under workers’ compensation, please contact one of our workers’ compensation attorneys.

Consult With Lawyer Now

The post Why is the insurance company denying medical treatment for my workplace injury? appeared first on Joepluta.

Help! The Insurance Company is Stopping my Temporary Disability.

Joseph Pluta — Fri, 03 Mar 2023 10:21:56 +0000

At the Law Office of Joseph Pluta, it’s not all workers’ comp all the time, it’s also a LOT about temporary disability payments. Here we examine a question we har a lot: What should I do when the insurance company stops my temporary disability??

So, you’ve gotten that letter from your adjuster telling you that your temporary disability payments are coming to an end in the near future and you want to know if there’s anything you can do about it. Well, the answer is—it depends. The biggest factor here is why did the payments stop. First, let’s look a little closer at Temporary Disability payments.

What is Temporary Disability?

Temporary Disability, or TD for short, is designed, as a temporary wage-loss replacement. Essentially, it is two thirds of your average weekly wage, subject to a minimum earnings floor and a maximum earnings ceiling. If you only suffer a partial wage loss as a result of your injury, then your temporary disability benefit is calculated at two thirds of your partial wage loss.

How do I qualify for Temporary Disability?

Qualifying for temporary disability benefits takes three things.

1: First, you must suffer a work injury that results in a loss or reduction of your wages.
2: Next, you must be made either temporarily totally disabled or temporarily partially disabled by the company doctor.
3: Finally, your injury must cause you to miss work for more than three days before your temporary disability payments start. But, if you miss more than 14 days, you will be paid TD for that three day waiting period.

Alternatively, if the company doctor makes you temporarily partially disabled, you have one additional hoop to jump through. If you are temporarily partially disabled, the doctor will allow you to return to work with restrictions. Your employer may then offer you alternate or modified duty. If you are offered alternate or modified duty which accommodates your restrictions then you return to work and you don’t get TD unless your modified duties pay you less than you were earning pre-injury. If your employer does not offer you alternate or modified duty, then you qualify for temporary disability benefits.

Are there any limits on Temporary Disability?

Per current law, you can only get TD for a maximum of 104 weeks and those 104 weeks must occur during the first five years after your date of injury. There are a few types of more serious injuries where the 104 week cap is extended to 240 weeks but these are uncommon situations and don’t apply to most people.

What can I do if my Temporary Disability is shut off?

The first thing you need to do is find out why. Then, depending on the reason, you may be able to see a judge for an expedited hearing. However, the judge cannot make a decision in your favor without medical evidence. If you’re still having a tough time wrapping your head around temporary disability, speak with an attorney. One small distinction with your individual situation may mean the difference between getting your TD again or moving on towards the next step in the resolution of your claim.

The post Help! The Insurance Company is Stopping my Temporary Disability. appeared first on Joepluta.

An Introduction to The California Workers’ Compensation System

Joseph Pluta — Fri, 03 Mar 2023 10:18:06 +0000

What is the California Workers’ Compensation system?

The California Workers’ Compensation system is not for the faint of heart. Originally conceived as an informal, easy-to-access system for injured workers, what exists today is very different. Whenever my friends ask me about the Workers’ Compensation system I always tell them the same thing—I sincerely hope that you do not find yourself inside the system because as an injured worker, the deck is stacked against you. That’s not to say that there’s nothing in the system for injured workers, but you need to tread carefully as you are often facing off with kind-seeming insurance adjusters helping their bottom line at your expense. With all that said, here’s a brief outline of the benefits available to an injured worker in California.

Do I get medical treatment for my work injury?

California law mandates that employers must cure or relieve injured workers from the effects of industrial injuries. What that means to you is that if you are injured at work and you report that injury to your employer, your employer must provide medical treatment to you for that injury. The kind of treatment you are entitled to and the limits upon that treatment will be discussed in a later article. But, suffice to say, just because you need a medical procedure does not mean that you will get it.

What happens if I can’t work after my injury?

If the Doctor your employer takes you to says that you are unable to physically do your normal work and takes you off work, your employer may offer you alternate or light duty. If they do not, your employer or their insurance company should pay you a temporary disability benefit. This benefit is paid while you are off work per your doctor’s recommendation. Temporary disability is calculated at 2/3s of your normal wage and is subject to other caps.

What if I have lasting effects from my injury?

If after your medical treatment, your doctor feels you have some level of permanent disability, he will assign you an impairment level which will then be converted to a permanent disability rating. The dollar amount of your permanent disability depends on your level of permanent impairment and your pre-injury earnings. The second opinion process will also be explored further in a later article. If the doctor says that you are unable to return to the same kind work due to your injury, you are also entitled to a voucher that can be used at accredited schools.

My spouse died from their injury, do I get any kind of benefit?

If the injured worker dies as a result of the work injury, his or her dependents may be entitled to a death benefit. The amount of the death benefit is determined by the number of total and partial dependents who survive the deceased injured worker. These situations can get complicated and it’s best to consult an attorney. As an injured worker traverses this maze, the workers’ compensation system presents many pitfalls. If you are confused, you’re not alone. If you have questions, you should consult a workers’ compensation attorney.

Consult With Lawyer Now

The post An Introduction to The California Workers’ Compensation System appeared first on Joepluta.