Legal Seafood

FAQ’s

Workers’ compensation carriers like all insurance companies are in the business of doing one thing: making money! Legitimate cases are often denied for invalid reasons simply in the hope that the injured worker will give up and obtain medical care through their private insurance. Think about it: if one hundred cases are denied and only twenty people hire an attorney and fight for their rights, insurance profit will go through the roof. Do not be a victim of a wrongful denial! Get a free consultation and have our office fight for the rights you are entitled to.

Often claims adjusters have so many files that they have no choice but to ignore your phone calls and your needs. This will result in delays in medical treatment and disability payments and add stress to your life. Our office will take immediate action in the event a benefit is being delayed or denied. We will get status of your claim if it is denied, delayed, or accepted and assure you receive benefits owed to you.

Workers’ compensations laws are very complex. Over the course of your claim, you will receive many letters (benefit notices) from the workers compensation insurance carrier containing information which may be confusing. Do not panic and do not get stressed. One of the main reasons an injured worker will hire an attorney is to get rid of the stress. My staff and I have seen and read these benefits notices for over 30 years. Both myself and my staff understand and can explain the meaning of each benefit letter. If you hire our office, the insurance carrier is required to provide our office with a courtesy copy of these benefit notices. This will allow you to relax knowing that your attorney has received the same letter and will take any action necessary to protect your interest. This should help lower the level of stress by knowing an experienced attorney is on your side.

The vast majority of injured workers are referred either by the insurance company or the employer to a medical clinic where they receive little or no medical care. Often the injured worker is physically examined by a physician’s assistant rather than a physician. Even worse they are immediately sent back to work despite the seriousness of their injuries. Our solution is simple and effective:  switch treating physicians. An injured worker has the right to select and designate their own treating doctor from within the medical provider network established by the workers’ compensation carrier. Based on my 30 years of experience, I can navigate the insurance carrier’s medical providers network and select the best physician available.

Employers will often ignore your injury as they are worried their workers compensation premiums will rise. This is not your concern. Your employer has a legal obligation to provide you with a workers compensation claim form within 24 hours of reporting your injury. Do not be a victim. If you report your injury and your employer does not give you a claim form, contact my office for a free consultation. We will immediately assist you in completing your claim form and filing your claim with the San Diego Workers Compensation Appeals Board.

Over the years I have handled many cases where the employer has encouraged or convinced employees to use private insurance. This is inappropriate. You have an absolute right to receive medical care for any injury sustained at work. It is your employer’s obligation to provide medical care.

QME’s are state appointed doctors that will provide medical opinions regarding various issues on your case. It is imperative that you select a reputable doctor within the right medical specialty. Our office will assist in selecting the best QME possible for your case and injury.

Many injured workers forget they are entitled to be reimbursed for each and every mile traveled to receive medical care. Over the course of a claim, this could add up to several hundreds of dollars. Our office will assist in obtaining all mileage due.

Injured workers are entitled to a benefit called temporary disability. Essentially, this is a wage replacement, and you are entitled to 2/3rds of your gross pay. Please keep in mind that if you have a second job or concurrent employment those wages can be factored in and raise your weekly rate. Over the years I have discovered benefits that many insurance carriers fail to inform the injured workers that they are entitled to additional monies.