For those who are injured while on the job, workers’ compensation can provide essential benefits, ensuring that their medical care will be paid for and that they will be compensated for some of the income they have lost. However, there are some situations where workers’ comp claims may be denied. In these cases, injured workers will need to understand their options for filing an appeal, including when their case may be heard by the California Workers’ Compensation Appeals Board (WCAB).

Requests for Reconsideration Before the WCAB

While all work-related injuries should be covered by workers’ compensation, regardless of who was at fault, there are a variety of reasons why a person may be denied benefits. An employer or their insurance company may believe that a person’s injuries were not work-related, or they may claim that certain types of medical treatment are not necessary. Disputes may also arise regarding whether an injury has resulted in a disability, and a worker may be denied temporary or permanent benefits that should address the loss of income they have experienced.

If a workers’ compensation claim is denied, a person will need to go through a specific process as they respond to this denial and request a review of their case. In some cases, a person may be able to resolve disputes by working with their claims administrator, or they may be able to negotiate a settlement with their employer. If a case cannot be resolved through these methods, a trial may be held before a workers’ compensation judge, who will review evidence and testimony and make a decision about whether benefits should be granted.

A serious injury can cause a great deal of difficulty in a person’s life, but those who are injured while working will often be eligible for workers’ compensation benefits that can ease some of the burden. When an injury is serious enough that it limits a person’s ability to work while they are recovering, temporary disability benefits will provide the person with compensation for some of the income they have lost. However, as the name implies, these benefits will only last for a certain amount of time, and workers who are subject to limitations on the work they can perform following an injury will need to understand how long they can receive benefits.

Understanding the Limits on TTD and TPD Benefits

A person will be eligible for temporary disability benefits if they require overnight hospitalization following an injury or if the doctor who provides treatment following an injury determines that they will be unable to return to work for at least three days. Temporary disability benefits will provide compensation for the income lost due to the inability to work at the level that would allow a person to earn the wages they received before they were injured.

Two different types of temporary disability benefits will be available depending on whether a person will be able to work at all while they are recovering. A person may receive temporary total disability (TTD) benefits if they are completely unable to work, or they may receive temporary partial disability (TPD) benefits if their employer offers them the opportunity to work at a reduced capacity, such as working for fewer hours or in a lower-impact position that pays less than what they previously earned.

When people think of workplace injuries, they are likely to picture serious accidents that result in significant bodily harm. While the need for workers’ compensation benefits may be evident in these cases, there are a variety of other injuries that workers can experience. Even though working in an office is not considered to be a high-risk occupation, office workers can be injured in multiple ways. These workers may experience repetitive stress injuries that may be caused by several different factors. Fortunately, all employees are eligible to receive workers’ comp for injuries that arose out of the work they have performed. By understanding the different types of repetitive stress injuries that may occur, office workers can make sure they provide the correct information to qualify for benefits.

Types of Repetitive Stress Injuries Affecting Office Workers

Repetitive stress injuries are caused by repeated motions or other factors that put stress on different parts of the body while a person is working. As office workers sit at desks, work on computers, and perform other daily tasks, they may experience injuries such as:

• Carpal tunnel syndrome - Regular use of the hands and fingers can place pressure on the nerves that run through the wrists. Damage to these nerves may lead to numbness, tingling, pain, or loss of control in the fingers and thumbs. Regular typing throughout the day can increase the likelihood of this condition, especially if a person holds their arms and hands in a position that places pressure on the wrists.

  ...

While there are multiple types of workplace accidents that occur on a daily basis, falls are some of the most common causes of injuries for workers. While these accidents can be especially serious for people in certain occupations, such as construction workers, they can affect employees in any industry. Fortunately, workers who are injured due to a fall that took place while they are working will usually qualify for workers’ compensation, even if they were responsible for their own injuries. By understanding the reasons that falls can occur in the workplace, workers can take the proper steps to avoid being injured while also ensuring that they will be able to receive benefits for any injuries that do occur.

Slips, Trips, and Other Types of Fall Accidents

While falls are more likely to be fatal for construction workers, since they may fall from a greater height and suffer more serious injuries, workers in other occupations are also at risk of being injured. These include people who work in healthcare, building cleaning and maintenance, transportation and delivery of goods and materials, and office workers. Some common causes of falls include:

• Wet or slippery floors - Liquids spilled on floors may lead to slip and fall accidents, and this can be an issue at hospitals or medical facilities, restaurants, or grocery stores. Wet floors can also be a safety hazard if a building does not use the proper floor mats at entrances to keep water from being tracked in from outside.

  ...

Workplace accidents can occur for a variety of reasons, and when these accidents result in injuries, a person will usually be eligible to receive workers’ compensation benefits. Brain and head injuries can be especially harmful, and those who experience these types of injuries will want to be sure they take the correct steps to receive the proper medical treatment. They will also want to determine how they can receive benefits that address the ways an injury has affected their ability to work in the future.

Benefits for Workplace Brain Injuries

There are a variety of situations where workplace accidents may cause a person to experience a blow to the head that results in a traumatic brain injury (TBI). Fall accidents, including those involving a slip and fall due to a wet floor or a fall from a defective ladder or scaffolding, may cause a person to strike their head on the floor or other objects. Brain injuries may also occur if a person is struck on the head by falling objects at a construction site or in a car accident that occurs while a person is working.

Workers’ compensation will pay for the costs of all medical treatment for a work-related brain injury. This includes any emergency treatment that is necessary, such as transportation in an ambulance, treatment at an emergency room, hospitalization, or surgery. A person may also need ongoing treatment, such as medications, physical or rehabilitative therapy, or psychological treatment to address mood disorders or post-traumatic stress disorder (PTSD), and these should be fully covered by workers’ comp.