Getting Started
Do I need a lawyer for my workers’ compensation case?
While you’re not legally required to have an attorney, having experienced representation significantly improves your chances of receiving full benefits. Insurance companies have teams of lawyers working to minimize payouts—you deserve someone fighting for your interests. Even if your claim seems straightforward now, complications often arise during settlement negotiations or when determining permanent disability ratings. An attorney ensures you’re positioned for maximum recovery from the start.
When should I hire a workers’ compensation attorney?
The sooner, the better. Early representation helps you avoid common mistakes that can hurt your case later. If your claim has been denied, your benefits have stopped unexpectedly, or you’re being pressured to settle quickly, you need an attorney immediately. Even if things seem to be going smoothly, consulting with an attorney ensures your rights are protected throughout the process.
How much does a workers’ compensation attorney cost?
Workers’ compensation attorneys work on contingency, meaning you pay nothing upfront. Attorney fees are capped at 15% of your recovery under California law, and you only pay if we win benefits for you. A skilled attorney typically recovers significantly more than the 15% fee costs, making legal representation a valuable investment in your case.
Benefits and Payments
What benefits am I entitled to under workers’ compensation?
California workers’ compensation provides several types of benefits: medical treatment (all necessary care fully covered), temporary disability payments (typically two-thirds of your average weekly wages while you can’t work), permanent disability compensation (if you have lasting impairment), vocational rehabilitation (if you can’t return to your previous job), and mileage reimbursement for medical appointments. The specific benefits you receive depend on your injury and circumstances.
When will I start receiving temporary disability payments?
If a doctor determines you’re temporarily unable to work due to your work injury, you should begin receiving temporary disability payments within 14 days of the insurance company learning about your disability. These payments are calculated as two-thirds of your average weekly earnings, up to the state maximum. If payments are delayed or denied, an attorney can help expedite the process.
Why did my temporary disability checks stop?
Temporary disability payments typically stop when: your doctor releases you to return to work (whether you actually return or not), you’ve reached maximum medical improvement (permanent and stationary status), you return to modified work at your regular pay, or you’ve received the maximum 104 weeks of benefits. The insurance company must notify you in writing within 14 days explaining why payments stopped. If your checks stopped without explanation or you disagree with the reason, contact an attorney immediately.
Can I receive other benefits if temporary disability stops but I still can’t work?
Yes. If you’ve reached permanent and stationary status, the insurance company must begin advancing permanent disability payments within 14 days of your last temporary disability check. You may also be eligible for state disability benefits through EDD, and your case might be ready for settlement discussions. An attorney can evaluate all available options for continued support.
Medical Treatment
My employer hasn’t sent me to a doctor. What should I do?
California law requires employers to provide medical treatment for work injuries. If your employer is ignoring your request for treatment, contact an attorney immediately. We can arrange for you to see an appropriate doctor at no cost to you and ensure your claim is properly filed.
Can I choose my own doctor?
After the first 30 days of treatment, you have the right to change to a doctor of your choice within the medical provider network (MPN) if your employer has one. If there’s no MPN, you can switch to any doctor you prefer. If you’re unhappy with your current doctor—especially if you feel they’re prioritizing the insurance company’s interests over your health—you have the right to change physicians.
What if I’m being treated by a “company doctor”?
Company doctors often prioritize getting you back to work quickly over your complete recovery. If you feel rushed, your concerns aren’t being heard, or your treatment isn’t adequate, you have the right to change doctors. An experienced attorney can connect you with medical professionals who will prioritize your health and accurately document your injuries.
Claims Process
Does my employer have to give me a claim form?
Yes. Your employer must provide a workers’ compensation claim form (DWC-1) within one working day of learning about your injury. Both you and your employer complete portions of the form. Your employer must give you a copy within one working day after you file it. Keep this copy—it’s important documentation. The claims administrator (usually the insurance company) then has 90 days to accept or deny your claim.
What happens if my claim is denied?
A denied claim doesn’t mean you’re out of options. Many denied claims are successfully appealed. Common reasons for denial include disputes about whether the injury is work-related, missed filing deadlines, or lack of medical evidence. An attorney can investigate why your claim was denied, gather supporting evidence, and file an appeal on your behalf.
Should I apply for state disability through EDD?
If your workers’ compensation claim is denied or significantly delayed, you can apply for state disability benefits through the Employment Development Department (EDD) as temporary support. However, you cannot collect both EDD disability and workers’ compensation temporary disability simultaneously. If your workers’ comp benefits begin while receiving EDD payments, notify EDD immediately to stop those benefits.
Working with Insurance Companies
The insurance company is cooperating now. Do I still need a lawyer?
Yes. Insurance adjusters work for the insurance company, not for you. While they may pay benefits initially, their goal is to minimize what the company pays you—especially during settlement negotiations. Early attorney representation ensures you’re seeing the right doctors, your injuries are properly documented, and you’re positioned for maximum recovery when it’s time to settle. Waiting until problems arise often means damage has already been done to your case.
Will I get more money if I hire a lawyer?
Statistically, represented workers receive significantly higher settlements than unrepresented workers, even after attorney fees. Skilled attorneys know how to document injuries properly, challenge low permanent disability ratings, negotiate effectively with insurance companies, and ensure all benefits are maximized. The 15% attorney fee is almost always far exceeded by the increased recovery a good attorney achieves.
Changing Attorneys
Can I switch lawyers if I’m dissatisfied with my current representation?
Yes. You have the right to change attorneys at any time if you’re unsatisfied with your representation. The 15% attorney fee doesn’t increase—it’s simply split between your current attorney and any previous attorneys. Your case and your recovery are too important to continue with representation you don’t trust.
Still Have Questions?
Every workers’ compensation case is unique. If you have specific questions about your situation, contact Pratt Law Corporation for a free consultation. We’ll evaluate your case, explain your options, and help you understand the best path forward.