Top 3 mistakes injured workers make in California when they don't have an attorney

This video reviews the three most common mistakes I have seen unrepresented injured workers make in California workers' comp cases (with another related mistake). If you are an injured worker with a California injury, and don’t have an attorney, this video is intended to help provide an overview of workers’ compensation topics so you can better represent yourself.
Nearly all injured workers will start their case by seeing a doctor chosen by the employer or insurance company. That is the way the system works. However, many injured workers stay with that initial doctor, no matter how much they may dislike the doctor. Whether they think it's too much work to select a new PTP, or whether they think it will take too long, or whether they simply do not know they can select a PTP on their own, many injured workers stick with that initial doctor when they'd rather not. In addition, many injured workers then choose to settle their case on that initial PTP without going to a new PTP or going to a panel QME. Lastly, many injured workers settle their cases with a C&R, resolving all issues, without ever talking to an attorney. The adjusters handle workers' comp cases all day, and have attorneys to advise them. A consultation with an attorney is free, and many injured workers would benefit from at least talking to an attorney.
Click here for the video on how to select a new PTP - • How do I get a new tre...
Click here for the video on panel QME versus PTP - • What you need to know ...
Jeremy Lusk is a certified specialist in workers’ compensation with almost two decades of experience, and previously served as a Judge at the Fresno District Office of the WCAB. He has worked out of Fresno, but appeared at numerous Boards to represent both injured workers and employers/carriers.
No attorney/client relationship is created or implied by this video. This video is not offering legal advice as to what you should, or should not, do in your workers’ compensation case, but rather offers education/information as to the California workers’ compensation system for unrepresented workers so they can better represent themselves and make more informed decisions.
If you have any questions, let us know at [e-mail]

[@williamlevi5051]

👍🏾👍🏾👍🏾 Keep being a voice for all us injured workers. Your advice is truly invaluable.

[@nightbat4107]

I was injured at work. Went to the hospital complaining of a bad headache, and major pain in my neck shoulder and wrist. They xray my chest and wrist then discharge, no pain meds and straight to physical therapy. They never treated my head or neck at all in the 3 years I was on workers comp. 4 months after the injury I find out my collar bone was broken. It's still broken ( 5 years later) . They basically financially killed me in to settling. The pains been getting worse and worse and idk what to do. No doctor will treat me because it was workers comp. What do I do? Please help me!!!

[@saberasarmin6467]

Thank you.

[@myworkerscompguide]

Happy to help inform.

[@markhernandez3879]

Hello Do you have an office here in california

[@yvonnemichelle2010]

Injured back at work as RN. Pt 500+ lbs no bariatric labor beds. Herniated a couple discs, SI pain. After pt, inj, etc, still pain but back at work fu duty. It sucks but I feel like my job wld be in jeopardy. MD was great but frustrated..said I was MMI rating 8% 3% for pain and another 4% for age and job. MD said do a C &R so you can get real help because they are going to keep denying. I asked and wc said no because I still work there. I feel they are rushing me as I don’t even have a primary anymore. WC said find new MD w/ concerntra. Now last week no go back to your DR (even though they spoke horribly about him). I just want to make the right choice. ( had knee from fall in 2018 and they denied MD, IMR and QME requests) and I got frustrated and settled.

[@jamesfallen714]

Where do find a good attorney? for workers comp... video's are helpful thank you

[@myworkerscompguide]

One of the best places to start is to look for an attorney in your area who is a certified specialist in workers' compensation. They are certified by the State Bar and have to pass a specialized exam in workers' comp. You can search at this site, and click on "Advanced Search" to look for workers' comp and your county. It will list attorneys who represent injured workers and insurance companies. But it will help start your search. apps.calbar.ca.gov/attorney/LicenseeSearch/QuickSearch#searchlink

[@jasonflores3576]

Hi 👋🏽 My name is Jason Flores and I have a lien conference hearing Nov 30th. I’m in Southern California and I’m not sure what to expect at this hearing and I would love to ask some questions. Thank You for your time in advance.

[@myworkerscompguide]

Lien conferences generally only take place once the injured worker's case has settled, and the lien conference will be between the defense attorney and the lien representative. They usually deal with outstanding medical treatment billing, and on rare occasion with an outstanding EDD lien. Many times the lien conference Notice of Hearing from the WCAB specifically says the injured worker does not need to appear.

[@luisbarrera4688]

From California my dr provider said before physical therapy on my last appointment about settlement I’ve been out of work since November had surgery but have not yet started physical therapy broke my leg in three spots how much is a case like a his worth in the 100,000

[@myworkerscompguide]

It's tough to say what a case like that would be worth at this stage. The key is that the permanent disability is determined once your condition becomes permanent and stationary, and it sounds like you just had surgery three months ago, so it may be a while before your case is really ready to settle. Once your condition is P&S, then you likely will need to see a panel QME, and then your whole person impairment will be addressed as well as anticipated future medical care. Then you can start to figure what the case is worth. The good news for recovery is that if broken bones are properly aligned and heal properly, often times there is minimal permanent disability. That's good news for recovery and getting back to life, but bad news for the dollar value of the settlement. If the recovery doesn't go well, my recommendation would be to reach out to an attorney for a free consultation.

[@YOMAMAA1]

I had hernia surgery on one side of my body even though I told the doctor I had similar pain on the other side. Because the initial report didn’t specifically state both sides they refused to work on both sides now I have returned to work and I’m having that same hernia pain all over again on the left side what should I do? My case has been closed for about 5 months

[@jeremylusk3493]

If you settled with Stipulations with Request for Award, you may need to file a Petition to Reopen for New and Further Disability so you can go back to your QME or PTP for a re-evaluation to address the hernia on the other side. If you settled with a C&R, then your case is closed and it is very difficult to reopen such a case. You may want to reach out to a local attorney for a consultation as there are a number of possibilities such as a Petition to Reopen, or a Petition to Set Aside, or possibly a new claim for a new injury.

[@bermudezfamily3570]

So I’m from California and had my finger broken while at work I went to dr for about 7 months to where they finally sent me to a hand specialist the hand specialist recommended surgery to take the bone out that never healed back in place and to take out some Neuromas that had formed so I just had surgery about 2weeks ago and they have token the Piece of bone out and the neuromas out will I get paid for this?

[@myworkerscompguide]

You'll likely get temporary disability, which is 2/3 of your average weekly wage, while you are off work due to the surgery. As to permanent partial disability, that will depend on your condition once you are P&S. So if you have loss of range of motion of the finger, or loss of grip strength, that type of thing, then there will be some ratable PD and for that you'll get paid.

[@aaron.z1207]

im in california and i was hit in a parking lot by a temp employees car while doing security. first doctor was beyond horrible degrading actually. second doctor helped me get mri which shown buldge in lower back . ive only recieved 1 check from workers comp since november ! help me with some real advice for. e and my lawyer please. thanks

[@myworkerscompguide]

There is quite a bit of information that would be needed to determine what you should do in your case. If the case is accepted and you're off work, you should probably be getting TD checks every two weeks. If the case is accepted, then the PTP should probably be working on getting you to a specialist or orthopedic consult. If the case is denied, then the goal has to be overcoming the basis for the denial so insurance accepts the claim. However, as you have an attorney, he or she will know best what to do. He or she will know the facts of your case and the strategy to employ. So my recommendation is to reach out to your attorney for answers, as that's what he or she is getting paid to do - to represent you.

[@pickined]

Neither the company or their insurance company sent me to a doctor and denied workers compensation. I do have legal representation, but have no income. Would going back to work while injured jeopardize my fight for compensation?

[@myworkerscompguide]

I always tell my clients to do what is best for them (such as returning to work so you have an income) and let me worry about the workers' comp case. In your case, I'd recommend asking your attorney, as he or she knows your case best and can make recommendations specific to your case/facts.

[@djdaviddelossantos930]

Hi I'm from cailforna and I lost my toe in a accident at work and I'm getting workers comp. My question is how much is my case Worth.

[@myworkerscompguide]

It will depend on which toe or toes, and how much of the toe was amputated. However, a strict application of the AMA Guides might not be appropriate if you are limping due to the amputation. So there are a number of variables. Plus, the value of future medical, if a C&R is an option, can vary widely depending on what the doctors are anticipating for future care, if any. You would probably be best served by seeing a QME, possibly a podiatry specialist. I'd also recommend meeting with an attorney to go over your reports to get a better idea as to the value of your case.

[@Mister-J]

From California, on workers comp for elbow injury. Ware and tear. Adjuster says I'll probably not ever be able to return to my job since I can't perform the required lifting. (Lose my job) will a lawyer be able to help me keep my job with permanent restrictions? I also have a union. (UPS)

[@myworkerscompguide]

It depends. A local attorney who knows the best treating doctors can often help you get into the best treating doctors so that you have the best outcome and the best odds of returning to work. Plus, a local attorney can likely steer you to a QME who is more likely to work with you as to restrictions. If your condition isn't yet P&S, then the adjuster is probably just guessing that you won't be able to return to work. However, you may want to reach out to an attorney locally. You can search for certified specialists in workers' comp at the State Bar website by doing an Advanced Search here - apps.calbar.ca.gov/attorney/LicenseeSearch/QuickSearch

[@AmirIslami]

Interested to hear an update on your case. I have a similar situation.

[@trinepimentel9693]

Hi,what happens when insurance company says it won't pay disability insurance because QMe gave you a low rating? Thanks

[@myworkerscompguide]

It depends. If the insurance company says it won't pay further permanent disability advances because the whole person impairment found by the QME is so low, then your only options are likely to be to get the QME to find a higher level of WPI, get the QME to find less apportionment to non-industrial causes, take the case to trial to get the QME report thrown out so you can get a new QME, or get your PTP to write a report finding a higher level of WPI to rebut that of the QME. Or it may be that you have additional injuries/conditions that the current QME cannot address as outside of his or her specialty, and there may be need for an additional QME. Any of those will likely be an uphill battle, and you'll likely be best served by reaching out to an attorney for a free consultation.

[@trinepimentel9693]

@@myworkerscompguide thanks alot I got another Qme visit in 2 months hopefully to get a non industrial rating from him..My first Qme visit was a % 2 rating pretty low I suppose..

[@epicrage52]

Hi I’m in California with 23% permanent disability I have right and left rotator cuff surgery and herniated disc ,any idea how much I worth ?its cumulative injury

[@myworkerscompguide]

If it is a final 23% PD rating after age and occupation, and assuming a weekly PD rate of $290, then the PD has a value of $26,245. However, many injured workers see the WPI figure in the QME report and think that is the PD rating. That WPI still needs to get adjusted by the DFEC modifier, age, occupation, and apportionment to get the final PD rating. Then, that PD rating is on the PD value of the case. If settling with Stips, the case will usually settle at that PD rating. If settling with a C&R, then the PD is just one factor to be added to future medical and closure value, generally.

[@user-ik4oo9dy1b]

Stuck with a bill from an emergency room visit that happened while working. Looks and feels like every one is hiding. What should I do ? Thanks

[@myworkerscompguide]

Two things. First, send the billing to the adjuster for the workers' comp claim and tell them to pay it. Second, tell the hospital or billing company that it was for workers' comp and give them the information for the adjuster so they can send the billing to the adjuster.

[@user-ik4oo9dy1b]

@@myworkerscompguide Thanks for the rare information. My coworker who also was sent to ER paid his bill out of his pocket not knowing this and now he trying to get his money back.

[@livelaughlove1681]

Thank you for your video! I would love your thoughts on my experience with worker’s comp lawyer. After a stress related worker’s comp case, my lawyer advised me to settle for $10k. I rejected this, and painfully negotiated with my lawyer over months, until lawyers agreed to C&R for $40k. Every step of the way I felt as if my worker’s comp attorney worked for the insurance, discrediting me and try to settle for less, while I was my own attorney. In addition, my WC lawyers discouraged me from going to QME. I ended up not going just to not deal with these lawyers any more and took the C&R (for $25k, reduced because I refused to sign general release form) Do you think I should’ve gone to QME?

[@myworkerscompguide]

There's really no way to know. I've had cases in which discovery continued (such as with a QME, or multiple QME's) and the value of the case went up. I've also had cases that parties decided to continue discovery and the value of the case went down. I've had cases in which the QME made the value of the case drop because they found that part of the problems were due to a non-industrial condition, and I've had cases in which the QME brings in new body parts. You just never know. Your attorneys would have known the strategy on your case best. There is no point now in trying to figure out what may have been as there are so many variables.

[@dreamdivine401]

Hi I was wondering if you have suggestion for a attorney. I need consultation

[@myworkerscompguide]

I generally recommend a two-pronged approach. First check the State Bar of California website for an attorney search. You can do an Advanced Search to look for attorneys who are certified as specialists in workers' comp in your city or county. That will narrow it down to attorneys who really focus on workers' comp and who passed a rigorous State Bar exam on workers' comp issues. Second, you can use Google to narrow down that list, as the list from the Bar will include attorneys who represent injured workers as well as attorneys who represent insurance companies.

[@dreamdivine401]

Thank you so much @@myworkerscompguide

[@myworkerscompguide]

@@dreamdivine401 Best of luck to you.

[@godsbelieverletitbe8476]

How can i contact you ?

[@myworkerscompguide]

You can email [e-mail]

[@YOMAMAA1]

How can I get a hold of you?

[@themultiverse5447]

I know it's probably too late but I emailed the creator of the video and got a response next day. Maybe this video doesn't end like the newer ones with his contact...IDK

[@bgda9god817]

I was denied C&R by the insurance company but QME was in favor of me and insurance company requested supplemental report from QME and that report was also in my favor now I have a MSC, what should I expect for settlement with life time medical for carpal tunnel, cubital tunnel and surgery in both hands from a hand crushed accident?

[@myworkerscompguide]

If the insurance company doesn't want a C&R, then the only option to settle will be Stipulations with Request for Award. In that case, they pay out the permanent disability based on the rating of the QME report. They will then keep medical open, so you can continue to treat as long as you need to, and workers' comp will pay for it. So without a C&R, they won't pay you for any of the future medical. You just get to keep treating. The only payment they'll make to you will be the checks every two weeks until the PD is paid out, and there should be a DEU rating for whatever that PD rates out to.

[@Jussjokez]

I have stress and depression from being sexually harassed by female managers also being bullied and retaliated against for reporting these instances and others. How can I maximize my mental health status at this time?

[@myworkerscompguide]

I'm not sure what you mean. If you have filed a workers' compensation claim, and the claim has been accepted, then insurance will pay for treatment to cure or relieve the effects of the injury. If the claim is not accepted, then you may need to treat through your personal health insurance until the claim is accepted. You may want to talk to your local I&A Officer at the WCAB or talk to a local attorney for a consult.

[@alfmuss3]

How about after dismissing your attorney for non investigation of your case and conspiring against the injured worker. Then winning case on our own. It puts a bad taste in your mouth. WC Judge, even stated my case file had been destroyed in Sacramento, Ca. Even after we informed all parties at trial the we had just copied the complete file two days before the trial at the W.C.A.B. In Oakland Ca. But still telling us in court it had been destroyed, without even investigating our claim. We copied and paid for, all the copies with checks and time stamped. Now what legal avenue do you have. Rambling but all provable. Still fighting.

[@myworkerscompguide]

I can't say as to your individual case. It depends on what legal avenue you are looking for. Against your former attorney? Against the judge? Against the insurance company? If it is against your former attorney, I'd recommend reaching out to attorneys who handle legal malpractice cases for a consultation. I have no experience in that area of law.

[@jeffconn8433]

California is a broken system the defense doctors are rude sometimes But there being told by the 3rd party opposing attorneys to discriminate on that's person patient so its the applicants attorney behind it A person can sue there attorney for medical proof that not in the compromise and release and you will find in the compromise and release the body parts are not listed and by the board of ethics they are to be indivudally listed by the applicants attorney and if not you the applicants can sue for all damages not listed in the court order so be aware of the fraudulent system of the 3rd party opposing applicant attorneys in california its a legal malpractice breach of contract Fudishuary of duty case

[@TheHellokitty46]

Hi I am from California I have stress claim

[@myworkerscompguide]

Stress claims can be some of the toughest to fight. Insurance companies almost always deny them and ending up in a trial is not uncommon if no settlement is reached. If you don’t have an attorney you may want to consider reaching out to one for a free consultation.

[@TheHellokitty46]

@@myworkerscompguide I got attorney my supervisor harrassed me stress me out for 3 years I went the managers and hr and nothing was done . She finally quit I am seeing a phyogistist right now. I was told my job was neglected because they knew and done nothing. Thank you for your advice

[@myworkerscompguide]

@@TheHellokitty46 I'm happy to help inform how this system works. As for anything on your case, obviously talk to your attorney. Best of luck.

[@mrpersianality6363]

An attorney will take a lot out of a settlement so the smaller amount is more than what you'd get with an attorney

[@myworkerscompguide]

An attorney in California will generally get a 15% fee on the final settlement. I've had many occasions when an injured worker comes to me ready to settle, signs up with my office, and we settle the case for much more money. I point that out to my client that they were ready to settle for $5,000, then I handled their case and worked up a settlement at (for example) $30,000, which would mean more than $25,000 in their pocket after fees. So yes, I'd get a fee of $4,500. But the client gets $25,000 in their pocket instead of $5,000. For those who would rather take the smaller settlement on their own, they are free to do so, and that's why I created this channel to explain the system. I spoke to them often when I served as a judge. But I suspect it is very rare that an injured worker gets less money by having an attorney.