work injury claim form with a judge's gavel

RESTAURANT EMPLOYEE PUNCHED IN RANDOM ATTACK: INJURED WORKER IN THE NEWS #124

It was recently reported that a Bartender got punched by a brute.  Nypost.com.   The same violent individual also smashed a customer in the head with a pole.
It is reported that the worker, a Bartender, had limited health care options.  As a result, he declined to take an ambulance ride as he was concerned about the cost.
This fact pattern will be analyzed within California Workers’ Compensation Law.  

What Did The Worker Get Wrong?

In California Workers’ Compensation Law, Labor Code Section 5402(c)(2) provides that “within one working day after an employee files a claim form under Section 5401, the employer shall authorize the provision of all treatment, consistent with Section 5307.27, for the alleged injury and shall continue to provide the treatment until the date that liability for the claim is accepted or rejected. Until the date the claim is accepted or rejected, liability for medical treatment shall be limited to ten thousand dollars ($10,000).”
In this circumstance, the Bartender should have submitted a claim.  His employer would then have been responsible for paying for the ambulance and the medical care required to treat his injuries.  Additionally, in California, there is a Victim’s of Crime Board that could have taken care of the medical bill. 

Beyond Treatment, Why is Medical Care Important?

Medical care, in workers’ compensation, also is a source of evidence.  Medical reports are considered as evidence concerning injury.  In this instance, physical signs, such as bruising, as well vital signs, i.e. blood pressure, are documented.

What If I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

 

 

deeply worried old man consoled by his wife

WAS HOSPITAL WORKER INJURED AS A RESULT OF PLAYING THE ROLE OF AN ACTIVE GUNMAN? INJURED WORKER IN THE NEWS #84

A Hospital’s Active Shooter Drill apparently went amuck. Psychiatric Hospital Worker asked to play the role of an Active Shooter was arrested when the Police were not aware of the drill.  As a result, he was handcuffed. According to a lawsuit filed, the Hospital Worker “heard the safeties come off the police officers’ weapons. [He] was scared for his life.”

It was further reported that he was traumatized and he “It’s really a struggle for me to come there every day,” he told the Free Press, adding that he returned to work the next day but left early because he felt uncomfortable.”  It was also reported that “he’s only received a “half-assed” apology from his supervisor, adding that counseling he was provided wasn’t useful.”  According to his lawyers, “he has suffered “anxiety, fear, depression and even suicidal ideation in the days, weeks and months since this incident.”  It was reported that “his lawyer is helping to get him mental health treatment after his request was denied.”  Detroit Free Press

What Was Applicant’s Occupation At The Time of the Injury?

Occupations, at the time of the injury, can determine the nature and extent of an Injured Worker’s permanent disability.   In this fact pattern, the Injured Worker engaged in an activity far different from his job as a Psych Tech.  Technically, one could indicate that he would be considered as an Actor.

In California, the type of employment allows for an occupational adjustment.  Occupational adjustments take place in the rating formula.  Bodily injuries are adjusted upwards and downwards based upon factors including arduousness.  For example, a furniture mover would get an increased rating for the low back injury.

With respect to this individual, a legitimate inquiry into occupational group would be indicated.  An actor’s mental capability might be considered more arduous or taxing versus a Psych Tech.

Are The Symptoms He Reported on Important for Permanent Disability?

Yes.  In California, the Injured Worker not only spelled out symptoms, he also commented upon his ability to function.  One serious symptom he indicated was suicidal ideation.  For functioning, his difficulty being a work setting is worthy of consideration.

In California, Psychiatric impairment are evaluated by the physician using the Global Assessment of Function (GAF) scale. The resultant GAF score shall then be converted to a whole person impairment rating.  To assess the GAF score both an individual’s symptom severity and level of functioning are considered.

What Are Injured Individual’s Treatment Rights?

The fact pattern indicates that the Injured Worker’s treatment was not helpful.

In California, an Injured Worker is able to choose their own doctor.  Even if an Injured Worker is within a Medical Provider Network from the Insurance Company, they are allowed to choose their doctor.  Thus, under Labor Code Section 4600, this Injured Worker, if they did not find the treatment helpful, could have changed to another doctor.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

blood disorder

6-Year Old Shoots Teacher: Injured Workers in the News #73

It is reported that an Elementary School Teacher was deliberately shot by a six-year-old student in her classroom.  She is reportedly critically ill.  Dailymail.com

This article will discuss this fact pattern under the premise that the Teacher was a Public School Employee within the State of California.

Are There Limits to This Teacher’s Workers’ Compensation Benefits?

In California, Workers’ Compensation Benefits are limited.   With respect to total temporary disability benefits, absent some exception, the Teacher, given the fact pattern, would likely be eligible for only 104 weeks.  With respect to medical care, while Labor Code Section 4600 provides for treatment to cure or relieve from the effects of the injury, the Teacher’s medical care would be subject to Utilization Review.  This means that Requests For [Medical] Authorization are subject to approval.

Beyond Workers’ Compensation, Is There Anything That This Teacher Can Do To Get Benefits?

If the Teacher is going to be unable to return to work within 104 week, it would appear that the Teacher should investigate her retirement rights.  Retirement can come in different forms.  Retirement can be based upon years of employment or based upon a medical disability.  In California, there is the California State Teachers’ Retirement System.   This system provides retirement benefits to California public school educators from pre-kindergarten thought community college.

Given this fact pattern, the Teacher should consult with both CALSTRS as well as the Social Security Administration for benefits.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

TACO BELL SHIFT MANAGER MISTAKENLY CAUGHT UP IN A CO-WORKER DISPUTE AND GETS SHOT: INJURED WORKER IN THE NEWS, #57

It is reported that a Taco Bell Shift Manager was shot in his shoulder by a Co-Worker.

Apparently, the Store Manager disciplined the Co-Worker.   Ater the discipline a Shift Manager then had an interaction with the trouble Co-Worker. This interaction led the disgruntled employee to get upset at the Manager.  The Co-Worker, who supposedly was slacking off on the job, got upset when the Manager told him that he could clock out if he didn’t feel like working.  The upset employee then took out a gun.  The Shift Manager tried to get away.  Unfortunately, he was shot.   It was reported in the article that neither the police or Taco Bell has acknowledged the workplace shooting. abc7chicago.com

This article will discuss what the Injured Worker needed to do when his employer is not taking responsibility for the claim.

When A Claim Is Not Acknowledged, What Should An Injured Worker Do To Get Benefits?

In California, there are disability benefits that may be available to workers.  “Disability Insurance (DI) provides short-term wage replacement benefits to eligible California workers who have a loss of wages when they are unable to work due to a non-work-related illness, injury, or pregnancy.” DIR.  State Disability will be paid when an industrial claim is being disputed.   Technically, an ignored claim is a disputed claim.

How Would An Injured Worker Get Treatment?

There multiple ways an Injured Worker can obtain treatment when a claim is not acknowledged.  An Injured Worker can seek treatment through their health insurance provider.   Also, they may be able to find a provider who can treat them on a lien.  When the claim is resolved, the health insurance or the lien claimant will seek payment from the Workers’ Compensation Insurance.

What Should The Injured Worker Do In This Circumstance?

The Injured Worker should speak to his Store Manager and ask for a DWC-Claim Form.  He should fill out and submit form to his employer.  If the Store Manager is not responsive, he should contact the corporate office for assistance in submitting in a claim form.

What if I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

ATTACK AT HOSPITAL WITH MEDICAL WORKERS STABBED: INJURED WORKERS IN THE NEWS # 40

Headlines reported that Encino Hospital Workers were attacked a stabbed by an Attacker.  These workers were reportedly in critical condition.  Dailymail.com

This article will discuss the immediate concern on this matter.

What Is the Major Concern with This Incident? 

Given the facts and the assumption that the same knife was used in the attack each victim, it is likely that the workers may have been exposed to each others blood.   Thus, a long term issue is the concern with respect to this injury is whether the workers were exposed to a  Blood Borne Illness.  Blood Borne Illnesses include Malaria, Syphilis, and Brucellosis, and Hepatitis B (HBV), Hepatitis C (HCV) and the Human Immunodeficiency Virus (HIV).  As such, treatment and monitoring for these illnesses would be part of the work injury protocol.  Thus, besides treating the Injured Workers  wounds and likely psychological injuries, an additional Internal Medicine Program will be included to provide prophylaxis treatment as well as testing and monitoring for blood borne pathogens.

What If I Need Advice?

If you would like a free consultation regarding workers’ compensation, please contact the Law Offices of Edward J. Singer, a Professional Law Corporation. We have been helping people in Central and Southern California deal with their workers’ compensation cases for 27 years. Contact us today for more information.

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