Injuries introduce themselves in different manners. Some are simple, you pick something up and you feel a strain in your low back. Others are not so obvious. You feel a twinge in your shoulder and it goes away for a couple of days, then comes back. It waxes and wanes but not enough to alert you to go to the doctor or even report it to your supervisor as a work related injury. Three months down the road you’re in excruciating pain. You figure you need to either

1. Report it as a work related injury or
2. Try to take care of it on your own thru private insurance

Why do you want to report it as a work related injury? The simple answer is because it happened at work. The cause is a bit nebulous however it came on gradually after doing something fairly routine at work.

What do you tell your supervisor as to how it was caused and when? This can be difficult to answer. We want to provide an answer to both these questions. Rather than narrow it down to a specific event such as I picked up a 50 lb bag of dirt and I hurt my back, you seem to recall your shoulder started to bug you a few months ago and now it hurts like crazy.

Worried that you will lose your job? Worried that you might lose a promotion? So you do nothing. That is what I do not want you do to.

How will filing a worker’s compensation claim will protect you?

You realize you are injured and you should take it easy so you think I will just ask my supervisor if I can transfer to a position that does not require me to do any shoulder work. Genius! You think. However, what you thought was a good idea turns to a nightmare. Supervisor asks why you need to do lighter work. You state that you have an injured shoulder.

Your supervisor should ask you if you injured your shoulder at work. If that is asked, then you should state the truth. At that point, he/she must give you a claim form.

Let’s say he/she does not ask you how or where the injury occurred and he/she says, no problem, we can have you do a job not requiring shoulder activity, however, he then goes to HR to state that you cannot perform your regular job duties. You have just set yourself up for a possible termination if they can’t accommodate you. Filing a worker’s compensation claim protects you from that situation. You cannot be fired if you have a workers’ compensation claim and injury and you are actively seeking medical treatment to stabilize the condition.

For example, say you decide to report the injury and the City sends you to a doctor. (N.B. the City has 90 days from receipt of your claim form to accept or deny your claim) That doctor/clinic examines you and determines a number of things ( none of which are in your best interest). The likely scenario is that the clinic sends you back to work with restrictions. Our shoulder claim has just received restrictions of no lifting at or above shoulder level on the right hand side. Depending on your job, you may not be able to perform regular duties. Can the employer accommodate those work restrictions? Does the employer have a duty to accommodate?

If the employer cannot accommodate then temporary disability payments must start. Temporary disability ( herein after T.D. ) T.D. is 2/3 of your gross average weekly wage. It is capped at $1128 a week. In addition you are allowed up to 2 years TD in most cases.

I have many times had clients come see me when the clinic they were sent to by their employer is stating that they can go back full duty when it is obvious to the injured worker that they cannot. So they will use their sick leave or vacation ….No bueno!

The problem is that the employer ( insurance co) usually has control of your treatment for the first 30 days. However, under most circumstances , you can retain an attorney during the first 30 days to get you out of the clinics ( US Healthworks, Work Partners, etc. ) and have your care transferred to a doctor in the Medical Provider Network.

When do I need an attorney?

My honest answer is at a minimum you need to consult with an attorney if you sustained an injury that requires you to be off work. The consultation is free and it is a great way to determine if you are receiving all of the appropriate benefits you deserve.If you need to have any of your workers compensation questions answered please do not hesitate to contact me at 858 693-8833


Lisa G. McLean Esq.

California State Workers Compensation Specialist