1. I was recently injured on the job, do I need a lawyer?
The decision to hire an attorney is yours. The Labor Code is set up to help injured workers with lawyers and without lawyer. However, the insurance company handling your claim is a business, like any other, whose main purpose is to make money. The representative from the insurance company may be friendly and cooperative, but remember: Making sure you get the maximum benefits the law allows is not their job. Having an attorney assist you with your claim is no guarantee that you will see an increase in benefits, but you cannot be punished or penalized by the insurance company for getting legal assistance, and in almost every case, if your attorney is well versed in current Worker's Compensation law, the benefits you receive will likely be more, sometime much more, than if you try to handle your claim yourself.
2. I was hurt at work, what happens now?
You have rights. First of all, your work probably sent you to their doctor after you were hurt. If you are not comfortable with this doctor or facility, you have the option of switching doctors soon after your injury.
Your doctor might say you a) can't work or b) might give you "work restrictions" and your work can't give you a job that fits those restrictions. If that happens, you do not have to work and are entitled to receive 2/3 of your wage/salary until your doctor decides you can return to work or your work can give you a job with the restrictions. This is called "temporary disability".
If your doctor feels you can work while you recover, or you are receiving "temporary disability" payments, you will be under the care of a doctor. During this time, you will receive medical care in an effort to heal and get you back to the physical level you were before your injury.
If the system worked perfectly, you would receive all of your money benefits on time, all of the medical treatment would be authorized in a timely manner, and the insurance company would offer you a fair settlement when you have recovered from your injuries. Unfortunately, this almost never happens.
3. The system didn't work perfectly, so now what?
To be honest, this is why injured workers need lawyers. The insurance companies will do everything from short-change you on your cash benefits, to deny medical treatment, to purposely send you to doctors they know will help them out, not you. (Unfortunately, there are doctors in the Worker's Compensation world that will say a very injured person is much less injured than they are to keep on the insurance company's good side).
Switching Doctors: The insurance companies have lists of approved doctors on their own Medical Provider Networks (M.P.N.). Thankfully, we are familiar with many, many doctors in the Southern California area and many doctors we would feel comfortable sending you to are on these Networks. Many doctors we wouldn't ever, ever send anyone to are also on these lists. An advantage to having an attorney is that we can make sure we will send you to a doctor that will consider your medical needs before worrying about the insurance company's financial interests. And if you aren't comfortable with the doctor we help you choose, we can always help you choose another until you find a doctor that you are comfortable with.
Denial of Disability Benefits: There are many situations that an insurance company will use to deny paying your Temporary Disability Benefits. If this happens, we can assist you in asking the Court (Worker's Compensation Appeals Board - W.C.A.B.) to resolve the issue by way of an Agreed Medical Examiner or State Issued Panel Qualified Medical Examiner (See #9 below for an explanation of Agreed Medical Examiner and State Issued Panel Qualified Medical Examiner) .
Denial of Medical Treatment: As with money benefits, we can resolve these issues in Court or with the use of an Agreed Medical Examiner or State Issued Panel Qualified Medical Examiner.
4. OK, so why do I need a lawyer?
1. Denied Case: You may have been injured on the job, but for whatever reason, your employer and/or the insurance company claims that you were not, or a deny specific parts of your body you say you injured while workingIf your entire case is denied, you will be denied all benefits until your case can be heard.We will argue your case at the W.C.A.B. if necessary and do our best to make sure you receive all benefits you are entitled to.
2. Denial of Medical Treatment or Denial of Benefits: As stated above, the insurance company will deny your benefits whenever they can. We are very familiar with local doctors who we can set you up with as Primary Treating Physicians. If we cannot agree on an Agreed Medical Examiner, and the P.Q.M.E. does not give us a report that we agree is in your best interests, we will take the matter to the W.C.A.B. to make sure we fight for all of your benefits. We will only agree on an A.M.E. we are familiar with who we know will have your best interest in mind.
3. Settlement: We know how to get top value out of Worker's Compensation cases. There have been, in the past year or two, a few new cases in the California Appeals Courts that are currently allowing us to increase the value of cases. Considering the serious damage that the changes in worker's compensation laws in 2004 did to injured workers, this is a possible remedy to the flaw in the law that Ufkes & Bright will use to make sure you get the best settlement possible.
6.Do I have any other benefits if I am hurt?
Yes. You are entitled to a Vocational Rehabilitation Voucher at a value which is determined according to your level of disability determined by the doctors.
7. What are the charges for your services?
In a Worker's Compensation Claim, our fee is 15% of the final settlement of your claim.
8. I have a question about my case, what should I do?
If we are the law firm handling your case, call us of course! Mark Ufkes is the handling attorney on all workers compensation claims. If Mr. Ufkes is in unavailable, Vincent Lopez is familiar with your claim and will assist you until Mr. Ufkes can call you back. We are a small firm and we limit our case load to make sure we have the resources to spend handling your claim. You will be able to speak with Vincent or Mark when you call or make a telephone appointment with Mark.You will always be welcome to also make an in-person appointment to discuss your case.
9.Why should I choose Ufkes & Bright to represent me on my claim?
We are a small firm. We make certain we have the resources to handle the claims we presently have.
You will meet and know your lawyer. One of the biggest complaints we hear from new clients that choose us over a previous lawyer is that they never met their lawyer. Honestly, that is ridiculous. Mr. Ufkes and his assistant, Mr. Lopez will meet with you personally and you will always be able to speak with one of them about your case when you have questions.
We know the law. The Labor Code can often be confusing. We are updated on any changes in the law and know how to use the recent changes to your benefit.
We have a history of excellence. My firm has been helping injured workers since 1969. We've had two former partners become Worker's Compensation Appeals Court Judges.
10. What is an Agreed Medical Examiner and State Issued Panel Qualified Medical Examiner?
When there is a dispute in your case, the parties will attempt to settle the issue by using an Agreed Medical Examiner or State Issued Panel Qualified Medical Examiner.
An Agreed Medical Examiner (A.M.E.) is a doctor who your attorney (on your behalf) and the defense attorney both agree to that will decide your level of disability, your need for current and future medical treatment and your current disability status (if you are temporarily or permanently disabled), as well as your entitlement to a vocational rehabilitation voucher. Under most circumstances, this doctor's opinion stands and is rarely defeated in Court, by either side, defense or Applicant.
A State Issued Panel Qualified Medical Examiner (P.Q.M.E.) is a doctor used if the parties can't decide on a A.M.E. The State of California gives the parties a list of three doctors and if an A.M.E. can't be chosen from the three, one party strikes one doctor, the other party strikes another and the remaining doctor serves as the P.Q.M. E. This doctor's opinion is often relied on by the parties, but hold no greater validity in Court than your treating doctor.
UFKES & BRIGHT 1970 Old Tustin Avenue, Suite B Santa Ana, California 92705 (714) 972-1111 (800) 649-2111 toll free (714) 972-1131 FAX