California has two different kinds of schemes for personal injury claims, depending on where you were injured. If you are injured at work, you will usually need to bring your claim through the workers’ compensation system. However, if you are injured during your leisure time, and your injuries were caused by the negligence of someone else, you will often be able to hold the wrongdoer accountable through the civil legal system through a tort claim. Typically, plaintiffs prefer to bring their claims under tort law because there is the potential for much greater damages to be awarded. The problem is that plaintiffs cannot bring a tort claim when workers’ compensation has been designated the exclusive remedy for the harm suffered. The California Supreme Court recently heard a case that addressed whether a specific kind of personal injury claim can be brought under a tort claim or whether it has to be funneled through the workers’ compensation system. This may all sound complicated – and it is- but a knowledgeable Southern California personal injury attorney can help you understand the best way to move your injury claim forward.
California Workers’ Compensation System
The court here explained that the workers’ compensation system gives employees relatively certain benefit payments, but they give up many kinds of potentially available damages in exchange. Part of the benefits provided by the workers’ compensation system is payment of necessary medical costs related to the injury. To ensure that the recommended treatments are actually “necessary,” the California workers’ compensation system has set up an independent review process. The process works by an independent reviewer who is tasked with approving or disapproving requests for treatment by program participants.
If a request for an allegedly necessary treatment is denied, the employee may appeal the decision to the Workers’ Compensation Appeals Board. If the board upholds the denial, then the employee can appeal to the California Court of Appeal. This case involves the denial of requested medical treatment and who is responsible for the damages caused by an improper denial.
Consequences of Plaintiff’s Back Injury
The plaintiff in this case injured his back at work. He suffered chronic pain which caused him anxiety and depression. As part of his treatment for anxiety and depression he was prescribed Klonopin. After taking Klonopin for about two years, an independent utilization reviewed decided to decertify the prescription, meaning that workers’ compensation would not cover it anymore. The decertification did not include any plan for weaning off the Klonopin, nor were any warnings given. After abruptly stopping the prescription, the plaintiff suffered seizures. The plaintiff then brought claims against the reviewers and others in superior court alleging negligence and other tort claims.
This case revolves around whether this case can move forward as a tort claim or whether it needs to go through the workers’ compensation system. The court here held that since the injuries are directly related to his work injury, the workers’ compensation system is the appropriate place to bring these claims.
Contact an Experienced Southern California Personal Injury Attorney Today!
If you are injured you should have a knowledgeable Southern California personal injury attorney on your side to help you access the benefits that you are entitled to. The attorneys at Neumann Law Group serves clients in Southern California, including Los Angeles and Huntington Beach and can help you pursue your personal injury claim. Use the contact form on this website or call (213) 277-0001 to contact us today!
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