Workers’ Compensation Benefits
In addition to the four basic benefits of Workers’ Compensation Law, an injured worker may be entitled to other rights depending on the circumstances. These might include:
- Third Party Cases
- Uninsured Employer Cases
- Intentional Injuries
- Unlawful Discrimination
- Subsequent Injuries Benefits Trust Fund Benefits
- Social Security Disability
- Reasonable Accommodation
1. Third Party Cases
Usually the only remedy an injured worker has against an employer is Workers’ Compensation Law and negligence is irrelevant. However, if the injury is caused by a third party, someone other than the employer or an employee, then the injured worker may have a workers’ compensation claim and a civil claim. For example if you are driving a truck for your employer and you are rear-ended by another driver you may have a claim against that other driver in addition to your Workers’ Compensation Claim.
Attorney Poe can make a referral to a lawyer who specializes civil cases if the facts of the case call for it.
2. Uninsured Employer Cases
California Workers’ Compensation Law requires that all employers provide workers’ compensation insurance for their employees. If a worker is injured while working for an uninsured employer, then the injured worker can sue the employer for civil damages in the civil courts in addition to claiming workers’ compensation benefits. The injured worker, in many circumstances, may be able to obtain benefits from a state agency called the Uninsured Employers Fund.
3. Intentional Injuries
If the injured worker is the victim of an intentional injury, such as when the boss attacks you, then the injured worker may sue the employer in civil court in addition to claiming workers’ compensation benefits.
California law prohibits an employer from discriminating or retaliating against an injured employee because he or she has made a claim for workers’ compensation benefits. Claims for discrimination most often end up in court before a workers’ compensation judge. The penalties for unlawful discrimination by an employer against an injured worker due to a work injury include lost wages, reinstatement, and a penalty of up to $10,000.
5. Subsequent Injuries Fund Benefits
If the injured worker had a pre-existing labor disabling injury or condition, that existed before the work injury, that worker may qualify for Subsequent Injuries Benefits Trust Fund (SIBTF) benefits from the State of California. The requirements are strict and difficult to prove. The requirements are that the work injury results in an impairment rating of at least 35% before adjustment for age and occupation, that the work injury when combined with the pre-existing injury or condition results in a combined rating of at least 70%, and that the pre-existing condition or injury was labor disabling. The pre-existing condition can be work related or non-work related. Unlike the underlying workers’ compensation injury where the workers’ compensation carrier is not entitled to a credit for Social Security benefits the injured worker may be receiving, the SIBTF is entitled to a credit for Social Security Disability Benefits and any other disability benefits the injured worker may be receiving. Nevertheless, if proven, a SIBTF claim will result in life time payments to the injured worker and are well worth pursuing. If you have a serious work injury that resulted in a rating of 35% or more and had a pre-existing condition, you will most likely need an expert, preferably a certified specialist in workers’ compensation law, to assist you in pursuing such a claim as these claims are complex and take expertise to gather the necessary information to prove it.
6. Social Security Disability
If a person is disabled or likely to be disabled for a year or more, he or she may be entitled to Social Security disability benefits if you have paid sufficient payments into your Social Security account. To obtain Social Security disability benefits the disabled person must show that he or she is disabled from all gainful employment, not just your usual and customary job. The Social Security disability claims are administered by the Social Security Administration and often require hearings before Social Security Administrative Law Judges. In serious cases, Attorney Poe can help you pursue a claim for Social Security disability benefits.
7. Reasonable Accommodation
The Americans With Disabilities Act (ADA), a federal law and the Fair Employment and Housing Act (FEHA), a state law, mandate that an injured worker or disabled person be reasonably accommodated by an employer if the modification or accommodation does not create “undue hardship” on the part of the employer. If the disabled person believes that the employer can accommodate or modify the employment so as to allow a return to work but refuses to do so, the worker may bring a claim in civil court under the ADA or FEHA in the appropriate circumstances. Attorney Poe specializes in Workers’ Compensation Law and Social Security disability and does not represent anyone in an ADA or FEHA case. However, in an appropriate case, Attorney Poe can make a referral to a lawyer to pursue such a claim.