Perhaps you sustained an injury while on the job and have submitted a claim to workers' compensation. You will be out of work for a few weeks, and you believe you are eligible for temporary disability benefits.
Unfortunately, you find your workers' compensation benefits denied, a decision possibly triggered by an improperly submitted doctor’s report, which could be a criminal violation.
Covering medical treatment
Workers' compensation laws went into effect more than a hundred years ago in our country, so you would think that by now they are well established. As an injured worker, you deserve to receive benefits for your medical care, including care related to temporary disability. It is your employer’s responsibility to arrange for your medical treatment during the first 30 days after the injury occurs. However, rather than seeing the company-approved doctor, you may use your own personal physician as long as you provide that information to your employer prior to the incident that resulted in your injury.
Submitting a DFR
By California law, the doctor who treats you for a workplace injury must file the Doctor’s First Report of Injury with the claims administrator. The insurance carrier must then send the DFR to the Department of Industrial Relations. However, the Department believes that some employers arrange for physicians to submit a DFR only to them, bypassing the insurance carrier altogether. Such an arrangement may be a way for companies to keep their insurance premiums from increasing, which constitutes fraud, a crime that may extend to the denial of workers' compensation benefits for injured workers.
If you believe a company wrongly denied your workers' compensation benefits, you can reach out for legal counsel. An attorney experienced with such cases will confirm that you have rights if you suffered an injury on the job, and a knowledgeable advocate will see that you receive all the benefits you deserve.