Is Worker’s Compensation Covered for Employee Negligence?
California is a no-fault state when it comes to workers’ compensation claims. This means, even if an employee’s own negligence led to the accident, they can still recover damages. There are times when an employer may challenge a workers’ compensation claim and make it difficult for the injured person to recover damages. If this situation sounds familiar, you can consult with the team at KJT Law Group. We can combat any allegations that complicate your claim’s progression and champion your right to damages.
Employee Negligence Is Covered by Workers’ Compensation
Employee negligence is what it sounds like; it’s when an employee’s negligence causes an accident and injuries. Here’s a situation to illustrate this term.
John is a truck driver. While completing a long-haul trip, he looks down at his phone to check the directions and collides with a stationary object. He suffers a back injury and files for workers’ compensation.
Even though John’s negligence caused the collision, he acted within the reasonable scope of his job when the accident happened. So, he would be eligible for workers’ compensation. However, this might not stop his employer and their insurer from contesting his claim. In that situation, John could benefit from consulting with a lawyer and having them handle his case.
You Can Recover These Damages Through Workers’ Compensation
Per the California Department of Industrial Relations (DIR), if you suffered a job-related injury, you can recover the full cost of your medical expenses, along with two-thirds of your average weekly wages. If you lost a loved one, you could recover death benefits, which would account for their funeral and other related losses.
Still, this doesn’t mean that the process will be easy. You need evidence to have a successful case, and with a lawyer, you wouldn’t have to worry about gathering these items on your own.
Who Is Eligible for Workers’ Compensation Benefits?
Per the DIR, every employee in California is eligible for workers’ compensation benefits. This means, even if you work part-time and suffer a job-related injury, you can seek damages. Every employer must carry workers’ compensation for their employees, even if they only have one. If your employer doesn’t offer coverage, and you get hurt on the job, you could sue your employer directly. You can’t sue your employer if they have workers’ compensation coverage.
Why Would the Insurance Company Deny My Claim?
When you file a workers’ compensation claim, you file it with your employer’s insurer. Like other insurance companies, it exists to make money collecting premiums––not paying for people’s losses. So, the claims adjuster may deny or contest your case if:
- They believe you were under the influence of drugs or alcohol.
- They believe that the injury is not work-related.
- The injury did not happen within the scope of your job-related duties.
- The deadline has expired, making you ineligible for damages.
The insurance company must give a written reason for a denied claim. This allows you to respond to the denial appropriately. For instance, if the claims adjuster doesn’t believe that your injury is work-related, you can offer evidence asserting otherwise. These could include witness statements, surveillance footage, and your medical treatment records.
You Can File an Appeal if the Insurer Denies Your Claim
The DIR notes that you can file an appeal after receiving a denial of your claim. However, this can get complicated. You’ll have to fill out seemingly endless forms, offer detailed information, and submit these items on time. For that reason, you could work with a lawyer who can manage the appeals process. They can file your appeal and present your case to a workers’ compensation administrative law judge.
Why Work With a Workers’ Compensation Lawyer? What Can They Do for Me?
If you suffer a workplace injury, you should consider partnering with an attorney from KJT Law Group. For instance, you only have 30 days to notify your employer. If you fear retaliation, your attorney can do this for you. They can also protect you from unlawful termination––all while pursuing the benefits to which you are entitled.
With a lawyer’s help, you wouldn’t have to worry about:
- Complying with deadlines
- Gathering supporting evidence
- Building a solid case
- Navigating bureaucracy
- Handling communications
- Protecting yourself from allegations of fraud
- Filling out and submitting paperwork
In the aftermath of a job-related injury, you deserve to rest and recover––not overextend yourself. By partnering with a workers’ compensation lawyer from our team, we can break ground on your case and advocate for you.
Our Lawyers Work on a Contingency-Fee Basis
You have enough to worry about after suffering an on-the-job injury. The last thing you need to worry about is affording legal help. So, we offer our services on contingency. Instead of asking for our attorney’s fees upfront, part of your awarded settlement pays for our help.
If your case doesn’t yield compensation, you don’t have to pay anything. This is just one of the many benefits of partnering with the workers’ compensation lawyers at KJT Law Group.
We Advocate for People in the Aftermath of These Injuries
You can seek workers’ compensation benefits if you suffered an injury that affects your working ability, such as:
- A traumatic brain injury
- Spinal cord trauma
- Organ damage
- Broken bones
- Nerve damage
You can seek benefits if you suffered an injury not on this list. Our team can explain more.
Begin Your Free Case Review With KJT Law Group Today
If you were injured on the job, you have the right to file a workers’ compensation claim and receive benefits–– even if you were negligent in your actions. California is a no-fault state, and thus, you do not need to prove how your injury took place as long as it was work-related.A California workers’ compensation attorney can help you recover the benefits you deserve and ensure that you receive the legal representation you need. To connect with the KJT Law Group team and learn more about your options, call (818) 507-8525.