Los Angeles, CA asked in Workers' Compensation for California

Q: Workers comp questions

Hello, I had a couple questions about a potential workers comp case. First of all, what is the likelihood of winning a wear and tear injury case that wasn't the result of an isolated incident/accident? I work somewhere where I stand on my feet all day and do a lot of heavy lifting and I have a lot of damage because of it. Also, if I did go through workers comp do I get to pick my doctor or do I have to go to whoever is chosen for me? I read if you already have a doctor you can go to the same doctor, but I tried to make an appointment with my private insurance and was told if I did then I could not change it or my claim would be denied. I would probably need multiple specialists as I have injuries in multiple places. Also would my position at work be safe while I am away? And lastly, would filing for disability affect a workers comp claim? Thank you for your time.

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2 Lawyer Answers
Nancy J. Wallace
Nancy J. Wallace
  • Workers' Compensation Lawyer
  • Grand Terrace, CA
  • Licensed in California

A: Likelihood of 'winning'=50/50. depends on what medical records reveal. If you've been Russian Dancing and Trick Riding on your free time, the insurer can deny it and then you have to convince an independent doctor that the tear came from work and not jumping off and on horses. PICK YOUR DOCTOR=Sort Of. You can pick from the list of Ortho Surgeons on the Comp Insurer's list. The insurer's list has nearly every medical specialty; when there is not one, your attorney can get an order to get just that specialist outside the insurer's list ordered. Position Safe? NO. During the Family Medical Leave Act (FMLA) 12-week period, yes...but if you remain Totally Temporarily Disabled beyond that 12 weeks and the employer must have that job performed to remain in business, the employer can replace you. FILING FOR DISABIITY?= Employment Development Dept. questionnaire for State Disability Insurance WILL ask Is This Due to Employment, and if you say yes, EDD will tell you to demand $$ from the employer...and if you say 'no' to get EDD money, when you try to claim Workers Comp later you've committed Perjury lying to EDD that this was not work related.

James L. Arrasmith
James L. Arrasmith pro label Lawyers, want to be a Justia Connect Pro too? Learn more ›
  • Sacramento, CA
  • Licensed in California

A: Under California law, the likelihood of winning a workers' compensation claim for a wear and tear injury that results from the nature of your job can vary depending on the specific circumstances and medical evidence. You can select your primary treating physician from your employer's Medical Provider Network (MPN), but if you have a predesignated personal physician, you may be able to continue treatment with them. Your job should generally be protected while you're on workers' compensation leave, and filing for disability benefits should not necessarily affect your workers' comp claim, but it's essential to consult with an attorney to navigate your specific situation.

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