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california work accident lawyerThere are many different types of accidents that may happen in the workplace, and in these situations, workers will need to understand their rights and options. Slip and fall accidents are among the most common causes of work-related injuries. Even though these may seem like minor incidents that will not result in long-lasting harm, they can cause a variety of injuries that may affect a person in the days and weeks following an accident. In some cases, they can result in ongoing health issues or permanent disabilities. Workers who are injured in fall accidents will need to understand the types of workers’ compensation benefits they can receive to address the effects of their injuries.

Common Slip and Fall Injuries

There are many reasons why slip and fall accidents may occur, including wet floors, damaged sidewalks, potholes in parking lots, or tripping hazards such as torn carpets or extension cords in an office or other locations. A person who slips and falls may experience injuries such as:

  • Broken bones - The impact of a fall may lead to fractures in different parts of the body. Bones in the arms or wrists may be broken when a person braces themselves against a fall. Fractures may also occur in the hips, ankles, or ribs. While a person may not require extensive treatment for relatively mild fractures, more serious cases may involve shattered bones or damage to the surrounding tissues, and surgery may be required to repair the damage. While a broken bone is healing, a person’s ability to complete work-related tasks may be significantly impaired.

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b2ap3_thumbnail_shutterstock_744694156.jpgThere are many reasons why work injuries occur. While some injuries may be the fault of an employee who did not follow the correct safety practices, many are caused by the negligence of other parties. In some cases, an employer may fail to provide employees with the proper safety equipment or training, or they may fail to ensure that equipment is properly maintained. Equipment-related injuries may also occur due to design or manufacturing defects. Fortunately for people who are injured by faulty or defective equipment while on the job, workers’ compensation benefits will usually be available to address their medical expenses and any temporary or permanent disabilities. By understanding the types of equipment-related injuries that can occur and the steps they can take following an injury, a person can make sure they will be able to receive the benefits they deserve.

Common Work Injuries Caused by Defective Equipment

Breakdowns can sometimes be prevented by enduring that equipment is properly maintained, but there are some situations where it may be difficult or impossible to predict and prevent equipment failures. Some common types of tools and equipment that may cause injuries include:

  • Ladders and scaffolding - Construction workers will often need to work above the ground, and they need strong, sturdy surfaces when doing so. Old, worn-out ladders may collapse, or they may fall over because they were placed on uneven surfaces without support. Scaffolding may collapse because of faulty components or because it was not assembled properly. These issues can lead to dangerous fall injuries.

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gilroy workers comp lawyerFor 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.

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gilroy workers comp lawyerA 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.

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b2ap3_thumbnail_shutterstock_709171012.jpgWhen 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.

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gilroy workers compensation lawyerWhile 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.

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b2ap3_thumbnail_shutterstock_195100124.jpgWorkplace 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.

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b2ap3_thumbnail_shutterstock_1190997985.jpgFollowing a work-related injury, an employee will usually qualify for workers’ compensation benefits. These include medical benefits that will pay for all treatment that is needed, including emergency care, doctor visits, medications, surgery, and long-term or ongoing services such as physical therapy or psychological treatment. The California Division of Workers’ Compensation requires reviews to be performed to ensure that the medical treatment a person receives is necessary to treat their injuries or illnesses. This type of review is known as a utilization review, and workers will need to understand how a review will affect the benefits they receive.

Different Types of Utilization Reviews

All forms of medical treatment that are covered by workers’ compensation are subject to review. A physician or provider will submit a request for authorization (RFA), and this request may be reviewed by a claims adjuster, physician reviewer, or non-physician reviewer. Requests may be fully authorized, partially authorized, or denied. Reviews will generally fall into one of the following categories:

  • Prospective review - In many cases, requests will be sent before medical treatment is provided. After an RFA is submitted, a decision must be made within five business days, and the provider must be notified of the decision by phone or fax within 24 hours. If additional information is needed, the provider must be notified within five business days, and a decision must be made within 14 calendar days after the RFA was originally submitted. If the provider is not notified of the decision or a request for additional information within five business days, they will be allowed to proceed with the requested treatment. In some cases, companies may create utilization review plans that provide prior authorization for certain types of treatment, and in these cases, a provider will not be required to submit an RFA.

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b2ap3_thumbnail_shutterstock_2002074008.jpgFor people who are injured in the workplace, workers’ compensation can provide crucial benefits that will allow them to receive the proper medical care and support themselves while they are recovering. In many cases, injured workers will suffer from temporary setbacks, and they will be able to return to their previous positions after they have fully recovered. However, there are some situations where a person may suffer from permanent impairments that make it difficult or impossible to continue doing the work they had done in the past. While permanent disability benefits may provide assistance in these cases, a person will likely be looking to find work in the future that will fit within their limitations. However, doing so can be difficult, especially if a person has limited experience outside of their previous position or if they do not have the skills to pursue other types of work. Fortunately, certain workers may qualify for vocational rehabilitation that will allow them to receive training and pursue employment in new fields.

Receiving Supplemental Job Displacement Benefits

When a work injury results in a permanent partial disability, a person may qualify for supplemental job displacement benefits (SJDB). In these cases, a person will receive a voucher for $6,000 that may be spent on job training and other forms of vocational rehabilitation. Up to $1,000 may be put toward the purchase of computer equipment that may be used during job training and job searches. $600 may be spent on vocational counseling, and $500 may be used to pay for miscellaneous expenses. The remainder of the voucher may be used to pay for training programs from one or more state-approved providers or for expenses related to obtaining a professional license, including exam fees, license application fees, and licensing exam preparation courses.

A person can only qualify for SJDB if they have not received an applicable job offer from their former employer. In some cases, an employer may offer a position with modified work that fits within a person’s limitations. If this offer is for a position that will last at least one year and will pay at least 85 percent of the wages the person earned before being injured, the person will not qualify for SJDB. If a qualifying job offer is not made within 60 days after a claims administrator receives a return-to-work report from the person’s doctor, the person will be able to receive an SJDB voucher.

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b2ap3_thumbnail_shutterstock_1492492898.jpgIn many cases, people who are injured while on the job will qualify for workers’ compensation benefits that will address their medical expenses and ensure that they receive a certain percentage of their income while they are recovering from their injuries. While workers’ comp laws apply to all employees, people in high-risk occupations may be able to receive some additional benefits and protections to ensure that they will have the financial resources they need as they address work-related injuries. Police officers will want to understand the laws that apply to them in these situations, and they can take steps to ensure that they receive the full benefits they deserve following an injury or work-related health condition.

Full Disability Benefits for California Police Officers

For most workers, temporary or permanent disability benefits provide compensation for a percentage of the income that a person is unable to earn while recovering from their injuries. However, California law states that police officers are entitled to receive their full salary when taking a temporary leave of absence to recover from an injury or illness that arose out of their duties. This leave of absence can last for up to one year, and after that period, an officer may continue to receive workers’ compensation disability benefits.

The following types of officers are eligible for full disability benefits:

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gilroy workers comp lawyerEmployees who experience work-related injuries are entitled to workers’ compensation benefits. These benefits, including coverage for medical treatment and partial compensation for income lost due to a temporary or permanent disability, are available regardless of who was at fault for an injury. If a person can show that they were injured in a workplace accident or otherwise suffered injuries or health issues that arose out of the work they performed, they will qualify for workers’ comp benefits. However, workers should also be aware of the potential for workers’ compensation fraud, including situations where employees or employers may be accused of committing fraud.

What Is Workers’ Compensation Fraud?

There are a variety of fraudulent activities related to workers’ compensation that may be committed by employers or employees. An employee may be accused of making a false workers’ comp claim in order to receive benefits. For example, if a person suffered a back injury after falling down while at home, they may contact their employer and falsely state that the injury occurred while lifting heavy objects at work. By doing so, they may hope to receive coverage for medical treatment, and they may plan to take time off work while recovering and receive temporary disability benefits.

Employers may commit multiple types of workers’ compensation fraud. In some cases, fraud will involve misclassifying workers as independent contractors rather than employees to avoid paying workers’ compensation benefits. Employers may also commit fraud by discouraging employees from making workers’ comp claims. For example, they may state that a particular type of work-related injury is not covered or that an employee does not qualify for benefits because they were at fault for a workplace accident.

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san benito county workers' compensation attorneyEmployers will often offer their employees the opportunity to work from home. This has been a significant benefit for many workers during the COVID-19 pandemic, since remaining in the home can help employees prevent possible infections while still ensuring that they are able to accomplish their daily tasks. However, as more and more people telecommute, situations may arise where employees may experience work-related accidents or injuries even when they are not in an office or a location that would typically be considered a workplace. In these cases, employees may be unsure about whether they are eligible for workers’ compensation benefits.

Eligibility for Workers’ Comp Following an Injury When Working From Home

Workers’ compensation provides benefits in most situations where an employee is injured in the workplace. Even though a person’s home is a separate location from the premises owned or leased by an employer, it is still considered a workplace if a person performs work there. Generally, an employee is eligible for workers’ comp if they were injured during the course of their employment, and the injury arose out of the work they performed. Eligibility is not affected by who was responsible for an injury; even if an injury occurred because of an employee’s mistake, the person will still be eligible for workers’ compensation benefits, as long as the injury was work-related.

Determining whether an injury that occurred in a home office or other areas of a person’s home was work-related will depend on whether the injury arose out of the work that the person performed. Injuries or illnesses that were directly or indirectly caused by work will be covered, but injuries caused by hazards in the home that were not related to work will usually not be covered.

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gilroy workers comp lawyerThere are many ways a person may be injured in the workplace or because of work-related activities and tasks. While workers’ compensation covers situations where employees are injured while working, there are some cases where workers and employers may disagree about whether an injury was work-related. These disagreements often address pre-existing conditions, and an employer may claim that an employee’s injury was solely the result of a non-work-related illness or health condition rather than the work the person performed or the conditions in the workplace. However, workers’ comp benefits are available in cases where a work injury resulted in the aggravation of a pre-existing condition. Workers with pre-existing conditions will want to understand how the California Department of Workers’ Compensation decides whether work-related factors aggravated their injuries or health issues.

Workers’ Comp Benefits for New Injuries or Illnesses

In general, workers’ compensation covers new injuries that occurred due to workplace accidents, conditions that affect a person while working, or work-related activities that a person engages in. An injury may be considered an aggravation of a pre-existing condition if a worker experienced a temporary or permanent increase in disability or required new medical treatment or changes in the medical treatment that they had been receiving. However, there are some situations where a recurrence of a previous injury or health condition may be considered an “exacerbation” rather than a new injury. 

To determine whether a pre-existing injury or illness was aggravated by a work-related injury, the Department of Workers’ Compensation may consider:

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gilroy workers compensation lawyerWhen working for an employer, workers have certain rights, including the ability to receive workers’ compensation benefits when they experience work-related injuries. While these benefits are available in most situations where a person suffers an injury or illness that occurred while they were working or was related to the work they performed, there are some situations where questions may arise about whether an injury was truly work-related. By understanding how work injuries are defined, a person can ensure that they will be able to receive the benefits they deserve.

Determining Whether an Injury Qualifies for Workers’ Compensation

Generally, an injury will be considered work-related if events or conditions in their work environment caused or contributed to the injury. This means that if a person was injured in a workplace accident or experienced health issues that occurred while they were working or because of work-related activities, they will qualify for workers’ compensation.

There are a few exceptions that may apply to injuries that take place in a person’s work environment, including:

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gilroy workers compensation lawyerA person who suffers injuries while working will be eligible for workers’ compensation benefits. In many cases, an injured worker will file a workers’ comp claim for injuries that occurred in workplace accidents. However, benefits are also available in situations where a person experienced illnesses or health issues that were related to the work they have performed. When addressing occupational diseases, workers can get legal help from an attorney who can help them understand the types of benefits they can receive and address any issues that may affect their ability to receive workers’ comp benefits.

When Is an Illness or Disease Work-Related?

Workers’ compensation is available to address any health issues that arose out of the work a person has performed. Work-related illnesses may occur because of issues such as:

  • Exposure to toxic chemicals - A person may be exposed to harmful substances due to an accident in the workplace. For example, a chemical spill at a factory may release toxic fumes that are inhaled by workers, leading to issues such as lung injuries, skin disorders, or chemical burns. A person may also experience health issues due to regular exposure to low levels of toxic chemicals. For instance, agricultural workers may be exposed to pesticides on a daily basis, and these chemicals may cause illnesses such as respiratory disorders or cancer.

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gilroy workers compensation lawyerBeing injured while on the job can lead to many difficulties, especially if a person is unable to return to work while they are recovering. If an injury is serious enough, it can permanently affect the types of work that a person can perform, and this can impact the income they will be able to earn during the rest of their career. Fortunately, a person who suffers an on-the-job injury will usually qualify for workers’ compensation benefits. However, navigating the process of filing a workers’ comp claim can be complicated, and it is important to understand how both temporary and permanent disability benefits will be handled in these cases.

Disability Benefits in CA Workers’ Compensation Cases

If an injury causes a person to miss more than three days of work, or if they need to spend the night in a hospital while receiving treatment, they can begin receiving temporary disability (TD) benefits. These benefits will provide two-thirds of the amount lost due to being unable to work. In total disability cases, a person will receive two-thirds of their pre-tax wages. In partial disability cases where a person can work part-time or at a lower wage while recovering, they will receive two-thirds of the difference between their pre-injury wages and the amount they are currently earning. Notably, TD benefits are calculated based on all of the income a person was able to earn before being injured, including hourly wages, overtime, salary, bonuses, tips, commissions, food and lodging expenses, and income earned from other jobs.

TD benefits may be paid for a maximum of 104 weeks within five years after a person was injured. These benefits will stop being paid when a person’s doctor releases them to return to the work they had formerly performed. TD benefits will also stop when a person reaches the point of maximum medical improvement (MMI), even if they suffer permanent impairments that will cause them to be unable to return to work fully. In these cases, a person may qualify for permanent disability (PD) benefits.

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california truck driver injury lawyerEmployees who suffer work-related injuries can receive workers’ compensation benefits that will address their medical expenses and loss of income due to temporary or permanent disabilities. These benefits may be available to truck drivers who suffer on-the-job injuries. However, a truck driver’s ability to receive workers’ comp may be affected by their classification as an employee or independent contractor. Those who have suffered injuries will want to determine their options for receiving benefits or other forms of compensation.

Legal Issues Affecting Workers’ Compensation for Truck Drivers

Employers are required to maintain workers’ compensation insurance that will provide coverage for employees who are injured while working. However, many truck drivers are classified as independent contractors rather than employees. Since they do not work directly for a trucking company or motor carrier, independent contractors may not be eligible for workers’ comp benefits. 

However, recent changes to the laws in California and ongoing court cases may affect how truck drivers are classified. AB5, a law that went into effect in 2020, applies what is known as an “ABC test” to determine whether a worker may be classified as an employee or independent contractor. Under this test, a worker may only be considered an independent contractor if they are not under the direct control of a hiring company when performing work, they perform work that is outside of a hiring company’s typical business practices, and they are involved in an independently established business or occupation. Under these rules, some truck drivers may be able to receive the benefits that apply to employees. The California Trucking Association has filed a lawsuit challenging this law, and a court has allowed it to be temporarily exempted from these rules. Depending on how this case proceeds, truck drivers’ ability to be classified as employees and receive workers’ compensation benefits may change in the future.

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gilroy workers compensation lawyerThere are multiple types of protections that apply to employees. Those injured in work-related accidents or who suffer health conditions because of their work have the right to receive workers’ compensation. A person will be eligible for these benefits no matter who was responsible for an injury. However, there are some cases where an employer or the company that provides them with workers’ compensation insurance may attempt to deny benefits by claiming that an injury was not work-related. If you have been injured in a workplace accident, or if you have suffered another type of work-related injury, you will want to make sure you take the correct steps to protect your right to receive workers’ compensation.

Steps to Follow After a Work Injury

  1. Report the injury to your employer - As soon as possible after being injured in a workplace accident or becoming aware of a work-related injury, you should inform your employer. You can notify a supervisor, a member of management, or a business owner. If you do not report an injury within 30 days after the injury occurred or after you discovered that work conditions affected your health, you may lose the right to make a workers’ compensation claim.

  2. Receive emergency medical treatment - Following an accident, you should go to an emergency room, urgent care center, or another medical provider to receive any immediate necessary treatment. When receiving treatment, you can inform the provider that your injury is work-related, letting them know that they should bill your employer for the treatment rather than requiring you to make payments.

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gilroy workers comp lawyerAnyone who has made an insurance claim is most likely familiar with the ways that a pre-existing condition can affect a case. Insurance companies may attempt to deny coverage because a person has previous injuries or existing health issues. This issue can also play a role in cases involving workers’ compensation insurance. An employer or their insurer may attempt to deny a claim by stating that a person’s injuries were not work-related but caused by a pre-existing condition. Injured workers will want to understand how to address these types of issues, and when they can make a workers’ comp claim based on the aggravation of a pre-existing condition.

Determining Whether an Injury Is Work-Related

Employees can receive workers’ compensation benefits for any injuries or illnesses that occurred due to the work they performed for an employer. In some cases, an employer or their insurer may claim that an injury occurred because of a person’s existing injuries or health issues rather than anything related to the work they performed. However, an injury or illness can only be considered a pre-existing condition if it was solely caused by an event that was not work-related or if it occurred outside of the work environment. If an injury or illness was partially caused by a pre-existing condition, the workers’ comp benefits a person can receive may be reduced based on the percentage of the injury that was related to their existing health issues.

Is an Aggravation of a Pre-existing Condition a New Injury?

If a workplace accident, an occupational illness, or the work a person performs causes a person’s existing injuries or health issues to become worse, they may qualify for workers’ compensation benefits. Typically, benefits will be available if the aggravation of a pre-existing condition is considered to be a new injury that occurred because of the work a person has performed. In general, a new injury must have led to temporary or permanent disabilities that are more serious than what a person had previously experienced, or new forms of medical treatment or changes to a person’s current treatment plan must be necessary to address the aggravation of a person’s condition.

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gilroy workers comp lawyerThere are many high-risk occupations where workers are at risk of being seriously injured. The agricultural industry is one of the most common sources of work-related injuries, and there are many ways that farm workers can suffer serious harm while on the job. Accidents involving tractors and other farm equipment can be especially dangerous, and workers who have suffered injuries in these types of accidents can work with an attorney to determine their options for receiving workers’ compensation benefits.

Common Tractor Accidents and Equipment-Related Injuries

Tractors are one of the most frequent sources of serious or fatal injuries on farms. Workers who are operating tractors or who are working near tractors or other equipment, such as harvesters and combines, may be injured because of:

  • Rollovers/runovers - Tractors or other equipment may roll over for a variety of reasons, including driving at unsafe speeds, striking rocks or other hazards, operating a tractor incorrectly on steep slopes, or improper use of front-end loaders or other equipment attached to a tractor. Negligent operation of a tractor may also cause a worker to be run over. If a tractor rolls over on top of a worker or runs over a person, this may result in serious bodily harm, including damage to limbs requiring amputation or spinal cord injuries leading to paralysis. A tractor operator may also be injured in a rollover accident if a tractor did not have roll bars or other safety equipment meant to prevent injuries.

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