Amputation Claim | Work-Related Loss of Limb
An amputation claim is traumatic on many levels. The pain and uncertainty of your injuries alone can be overwhelming. And if you’re unable to work due to your injuries, the stress is even greater. At the Law Office of Stephen Dewberry, our amputation claim lawyers guide injured workers through the complicated process of getting compensation for loss limb. Learn more about California workers’ compensation and amputation claims below.
Who Pays My Medical Bills?
If you suffer an amputation at work, your employer or its insurance company should cover all of your reasonable and necessary medical treatment. This includes bills for the ambulance, hospital, surgeons, physical therapists, medications, and prosthetic devices that you might need.
While disputes sometimes arise about the reasonableness and necessity of your medical treatment, most amputation victims don’t have to pay their work-related medical bills. If you get a medical bill related to your injury, you should ask the medical provider to bill the insurance company for your treatment. If the workers’ compensation insurer refuses to pay a bill, contact a California workers’ compensation attorney immediately.
Will I Get Compensation While I Recover From My Loss of Limb?
While you’re recovering from your injuries, your employer should provide you with temporary disability benefits. If you’re completely unable to work, you should receive a temporary total disability benefit, which is typically two-thirds of your average weekly wage. If you’re only able to work reduced hours, you should receive a partial benefit. These benefits should continue until your condition is stable and will no longer improve.
How Does California Workers’ Compensation Compensate You for an Amputation Claim?
While some states have a schedule that assigns a specific value to each body part, California doesn’t take this approach. Instead, amputations and the loss of a limb are considered permanent disabilities. You become eligible for permanent disability benefits once you reach “maximum medical improvement” or MMI, the point when your doctors believe your condition will no longer improve.
Once you are at MMI, the workers’ compensation insurance company will assess your permanent limitations. Based on the extent of your amputation, your functional restrictions, and other factors, you will receive a permanent disability award. Depending on the severity of your injuries, you might receive total or partial permanent disability.
Total Permanent Disability
California workers’ compensation law awards total permanent disability in amputation claims that result in your complete inability to perform work. Certain losses, such as the loss of vision in both eyes, are automatically considered totally disabling. In other claims, you must prove that your disability is total, using medical evidence and other information. Total permanent disability benefits are typically payable for your lifetime. Again, total permanent disability benefits are typically two-thirds of your pre-injury average weekly wage.
Partial Permanent Disability
If you have some, but not a complete disability, you can still receive permanent disability benefits for an amputation claim. In these claims, your compensation for loss of limb will depend on the extent of your disability. Typically, your doctor will set an impairment rating for you. If both you and the insurance company agree on the rating, you should receive your permanent partial benefits without a fight. However, disputes frequently arise over these ratings.
Because the calculation of permanent partial disability benefits is incredibly complicated, it’s typically in your best interest to consult with a workers’ compensation lawyer about your impairment rating and the amount of your award. A lawyer will help you assess your disability, determine the correct impairment rating based on your functional limitations, and fight for the compensation for loss of limb you deserve.
Filing a Work-Related Loss of Limb Report
After your injury, you should immediately notify your HR department or supervisor that you were injured. You may need to submit specific claims forms or evidence from medical providers. You will also want to submit a workers’ compensation claim with the California Division of Workers’ Compensation (DWC).
In most amputation situations, the employer quickly approves the claim. However, if your claim is denied or part of your medical losses are challenged, you should fight back. You deserve full compensation for your losses for your work-related amputation.
What If Someone’s Negligence Caused My Loss of Limb?
Although your injury may have occurred at work, you may be able to point to a non-coworker or another company that actually caused your injury. If a third party is to blame, you may be able to get compensation for loss of limb in addition to your workers’ compensation benefits.
When a Third Party Is to Blame
Some examples of situations where a third party may be to blame include work-related car accidents or product liability cases. If you were driving a vehicle while working and someone else caused your crash, they may be to blame for your loss of limb. This may make them legally liable for your financial losses as well. Another situation may be a defective piece of machinery that you use at work that causes your injury. In both of these cases, you can hold someone else accountable for your injuries.
An Injury Case Can Be More Complex Than a Workers’ Comp Case
A personal injury case against someone else for negligence is much more complex than a workers’ comp case. It will require you to prove that the other person or company owed you a duty, breached that duty, and you were injured and suffered losses as a result.
You can maintain a workers’ compensation claim and a personal injury claim at the same time. You can collect money from both as well. Workers’ compensation claims rarely fully compensate losses. Thus, a personal injury claim against the person who was negligent may help you recover all of your economic and non-economic loses, including:
- Medical expenses
- Wage loss
- Loss of earning capacity
- Mental anguish
- Pain and suffering
What If the Insurance Company Denies My Claim for Compensation for Loss of Limb?
If your employer or its insurance company denies your claim for benefits, you should immediately contact a lawyer with experience in amputation claims. Under California law, you have the right to file an appeal. However, these appeals involve complicated legal procedures and a detailed medical and vocational analysis. They also involve extensive negotiations with the insurance company’s lawyer.
Once the insurance company denies your claim for compensation for loss of limb, you should act quickly. There are strict filing deadlines in amputation and other workers’ compensation claims. If you miss this deadline, you’ll lose your right to compensation. For more information about the appeal process and your eligibility for workers’ compensation benefits, contact the Law Office of Stephen Dewberry.
Schedule a Consultation With a Workers’ Compensation Lawyer
If you have a claim for compensation for loss of limb, the Law Office of Stephen Dewberry can answer your questions. We focus on California workers’ compensation claims and tirelessly fight for injured workers. Contact us today for a free consultation.