Frequently Asked Questions – Page Four of Six

Workers Compensation Frequently Asked Questions – Page Four of Six

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What constitutes workers’ compensation fraud?

Fraud in the workers’ compensation system is extremely frowned upon by the attorneys at Eason & Tambornini and something that we will never take part. Fraudulent benefits paid out reduce funds needed to pay valid claims, and/or take away valuable judicial resources. Workers’ Compensation Fraud is when you knowingly make a false statement for the purposes of obtaining workers’ compensation benefits. Simply put, it is lying to receive benefits. The penalties for fraud can include fines up to $150,000 and imprisonment, often up to five years.

http://www.insurance.ca.gov/0300-fraud/0100-fraud-division-overview/10-anti-fraud-prog/Workers’-Comp.cfm

What does future earning capacity mean?

When you have a disability rating, a multiplier needs to be applied to that rating to determine future wages loss. This multiplier is referred to as the future earning capacity.

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What happens in a workers’ compensation hearing?

Workers’ compensation hearings vary depending on the particular issue. Traditionally, there are many different matters on the calendar for a particular time. When your matter is called, the judge will discuss with the attorneys the general nature of the dispute to refine the issues. Once the issues are narrowly focused, the judge will ask the attorney to submit into evidence various documents, including medical reports that support or refute the claims. Once the documents are introduced, the judge will often allow the parties to call witnesses when appropriate to provide live testimony. Each side typically has an opportunity to question the witnesses. Once the documents have been entered and the witnesses examined, the judge may permit the attorneys to summarize the evidence on the record, or in writing. This summary is referred to as closing arguments, which are generally allowed. Then, the judge takes the matter under submission/consideration. After considering the matter, the judge will typically issue a decision, often referred to it as a Findings and Award. If not timely appealed, the findings and award will become the final decision of the court.

http://www.dictionary.com/browse/evidence

What does in pro per mean?

In pro per is short-hand from the Latin “in propria persona”. It simply means someone who represents themselves.

http://legal-dictionary.thefreedictionary.com/pro+per

What does it mean to be an independent contractor?

The classification of an independent contract and/or an employee can have huge implications on your case. The most important thing to know is what your employer “labels” you or what you “agree to call yourself” is of very little importance. The decision of whether you are an employee or independent contractor is predominately based on who “controls” your work. Do you decide everything for yourself, including when and how to do your job, or is someone controlling your work? Some of the most important factors include:

  • Who decides the manner and way in which the work is done?
  • Is the contract for a specific period or can it be terminated at any time?
  • How are you compensated? By the job? By the hour? Fixed rate?
  • Who supplies your materials or tools?
  • Do you have to do the work on specific days or times, or can you decide yourself?

https://www.irs.gov/businesses/small-businesses-self-employed/independent-contractor-defined

What does the phrase independent medical examiner mean?

In the workers’ compensation context, an independent medical examiner is used interchangeably with the phrase qualified medical examiner. The phrase qualified medical examiner is now the preferred phrase, as the examiners are not always “independent” or neutral, and thus the word independent becomes misleading.

Where can I get help without seeking an attorney?

The Department of Workers’ Compensation has established the Information & Assistance Unit. The purpose of that unit is to provide information on how to proceed through the workers’ compensation system, and how to resolve disputes. It is solely an information service and they are not allowed to advocate for you or give legal advice. If you want an advocate, hiring a workers’ compensation attorney is best.

What is an IIPP?

IIPP stands for an Injury and Illness Prevention Program. It is a program enforced by CAL/OSHA that requires employers to develop and implement ways to make the workplace safer. Employers who have an unsafe workplace risk claims for Serious & Willful injuries.

http://www.dir.ca.gov/dosh/etools/09-031/

What is an impairment rating? How is it calculated?

An impairment rating is different than a disability rating. An impairment rating is an estimated percentage of how much use of your normal body parts you have lost and is based on guidelines established by the American Medical Association. The impairment rating is the used, along with other factors, to calculate your permanent disability rating for workers’ compensation benefits.

https://www.amazon.com/Guides-Evaluation-Permanent-Impairment-Sixth/dp/1579478883

What does it mean to have a lien in a workers’ compensation case?

A lien in a workers’ compensation case is similar to liens in other cases, or liens on other items such as homes or cars. It is an agreement, voluntary or involuntary, to reimburse someone when your workers’ compensation case is resolved. Workers’ compensation claims have special standing under the law and most liens do not apply to rights to benefits. If someone is threatening to, or wants to, put a lien on your workers’ compensation you should contact a workers’ compensation attorney.

http://www.investopedia.com/terms/l/lien.asp

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