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Claims for psychiatric injuries in California workers’ compensation are among the most complex and difficult to pursue. Unlike physical injuries, psychiatric (psych) injury claims are subject to additional statutory requirements, including the six-months of employment and predominant cause requirements, intended to make claiming psych injuries more difficult. Additional complexity comes from both those requirements having expectations. Finally, even if the requirements to bring the claim of injury are met, psychiatric claims are subject to a unique statutory defense.
Retaining an attorney for your workers’ compensation case is not required, but does give you an advocate to help you through the workers’ compensation process. You do not need an attorney to have a workers’ compensation case; you have a case start when you are injured at work. Your employer’s workers compensation insurance company also has legal responsibilities to give you information and notices that are intended to help you know what is happening with the injury and how to make it through the workers’ compensation process. The defendant’s duties to you do little to help you achieve the best outcome for you however.
One of the most frustrating aspects of California workers’ compensation is the Utilization Review process for medical treatment. That frustration is understandable: your treating physician believes you need care, so why won’t the insurance company authorize it?
After you sustain an injury at work, it is crucial that you promptly take action to take care of yourself and your claim of injury. Once the injury is reported to your employer, their workers’ compensation insurance company has up to 90 days to investigate if the injury genuinely occurred due to your job. This investigation period is called the delay period (delay phase above). Navigating the delay period is important because if the injury is accepted at the end of the delay period, you should receive medical and financial benefits from the insurance company. If the injury is denied however, it will take months or longer before you receive any benefits from the insurer. This article provides some general advice for taking care of yourself, and your case, during the delay period.
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