You are typically entitled to workers’ compensation if your injury was caused, aggravated or accelerated by your job. Filing the proper paperwork with your employer and hiring an experienced workers’ compensation attorney can greatly assist you in obtaining the maximum compensation available to you.

Employers and Insurance Companies

In 2004, the state of California changed the law to provide for even more protection for employers and insurance companies than they currently received. Workers’ compensation cases are now more complicated and more difficult to win than ever before. If you have been injured and have been denied claims or you are unsatisfied with the medical treatment you are receiving, consult a Ventura County workers’ compensation lawyer to learn about your options.

Burden of Proof

The State of California requires that you prove your workers’ compensation case with both factual and medical evidence – the burden of proof. The State requires that you prove medical issues (such as whether your injury was caused by industrial exposure) with expert forensic medical opinion. Until 2004 both the injured worker and the insurance carrier had the right to pick their doctor to provide that evidence.

The State then changed the system to significantly limit your ability to prove the medical issues, to save costs for the insurance industry. First, it limited access to medical care in most cases by requiring you to select a treating doctor off a list approved by the insurance carrier (the Medical Provider Network). These MPN doctors are understandably reluctant to advocate for controversial or difficult claims.

Qualified Medical Examiner (QME)

Second, it now requires you to pick a doctor, called a Qualified Medical Examiner (QME), off a panel of three that the state provides. The State requires that these doctors meet certain qualifying criteria and I believe most of them try to do a good job. However, the system assumes, naively in my opinion, that a doctor is a doctor is a doctor and that therefore all doctors will reach the same conclusions with a given patient. This has not been my experience!

If you have a work injury, remember that the QME report is an essential and determinative part of your case. The Rules are detailed and confusing but they can protect you against these out of town QME’s whose attitudes and findings are biased or otherwise inappropriate.

How a work injury lawyer can help you

Following a job-related injury, you may have related Social Security disability issues too. I am an aggressive, creative and energetic attorney who will help you make informed decisions and avoid hassles, stress and confusion in a process that can be weighted against you.

No standard solution applies to every problem, so I help my clients pursue the best course of action for each of their unique cases. It is important that injured workers know their rights and take advantage of the options available to them under the law. 

The Law Office of John H. Sugden can guide you through the complex legal process of pursuing a workers’ compensation or Social Security disability claim. I help you level the playing field.

Get Help and Protect Yourself

The bottom line: you have remedies. You may not know about them or how to protect yourself and you should consider getting a lawyer. I have specialized in workers’ compensation law for over 35 years. My office is easy to reach and my staff and I are here to help you. Contact my office for a free consultation »