Wednesday, March 26, 2008

Partial Workers’ Compensation Benefits for Partial Injury

Workers’ compensation is designed to award financial recovery for workers who get injured or harmed from their jobs. This is based on the principle of strict liability; therefore, an employer is obliged to pay for the damages his/her employee has sustained. He/she will be held legally responsible no matter of who was at fault.

But what if an on-the-job accident caused damages to a plastic surgery, such as breast implants? This was the case – and predicament – of a worker who was injured on a work-related car accident. Read more about this on “Asymmetry in Workers Comp” .

Her workers compensation claim was not entirely successful. Full compensation for her damaged breast implants was not awarded to her because her insurer contested that only one implant was damaged from the accident. The insurance company declined to pay for the replacement of her breast implants.
In accordance with the workers’ compensation rules which state that the injuries should be a result of an accident on the workplace, the court denied her claim on being fully-compensated for her breast surgery since the damage on the other half was from another cause.
Workers’ compensation benefits are defined by statutes. Hence, there are guidelines to follow in assessing a claim. As with the case of the worker discussed above, I agree that the insurers should not be responsible in covering for the entire costs of her breast surgery since there was only partial injury that was caused by her work-related car accident.
Workers’ compensation benefits in California are administered by the employers’ insurance companies or the employers themselves, who can afford workers’ compensation to their employees, and not by a government agency.
Thus, it is also their duty to determine whether the injury was sustained from the work or not. Prior to accepting a claim or providing provisional liability compensation, insurers require certain facts. An investigation shall be conducted on the claim. The worker, employer and the treating doctor will be asked to give their statements.
Disputes may arise out of a contention on whether the injury was indeed caused on-the-job or not; or an argument on the payment the worker is entitled to. When a dispute arises out of a worker’s compensation claim in California, the Division of Worker’s Compensation (DWC) comes in to help resolve the dispute.
On the other hand, a legal advocate may also assist individuals in earning their workers’ compensation claims. If a conflict regarding a claim arises, a lawyer may help prove the extent of damage the worker is entitled to.