California Workers’ Compensation Defense

Going Beyond Insurance

California, like most states, requires all employers to carry workers’ compensation insurance.  When a workplace injury occurs, an employee’s exclusive remedy is workers’ compensation benefits unless the injury falls within the scope of certain limited exceptions.  

Employers facing claims regarding workplace injuries that fall outside the scope of workers’ compensation coverage need California workers’ compensation defense counsel with more than a rudimentary understanding of workers’ compensation law.  Susan A. Rodriguez, an employer workers’ compensation defense attorney in California, is the one to call.

Effective California Workers’ Compensation Defense May Require Two Separate Attorneys

Generally, workers’ compensation is the exclusive remedy for workplace injuries. However, there are some exceptions to the exclusive remedy rule. Examples attributable to employee conduct include when the injury resulted from the employee’s horseplay or intoxication. Examples attributable to the employer’s conduct include when the injury was the result of serious and willful misconduct by the employer or when the employer discharges the injured employee in retaliation for seeking workers’ compensation benefits.

Workplace injury claims based on exceptions to California workers’ compensation coverage are not covered by workers’ compensation insurance.  Many policies do not provide counsel for defense against such claims, and, if the employee prevails, the employer is responsible for paying any damages awarded. 

In these instances, employers may need two attorneys: one lawyer to handle the benefits claim, and a California workers’ compensation defense lawyer to litigate the additional claims for increased benefits that fall outside of workers’ compensation coverage.  

More Than Benefits—Some Employees Want Damages

When a workplace injury occurs, the injured employee typically files a claim for workers’ compensation benefits.  An employee who believes that his or her injury falls outside of workers’ compensation may also sue the employer for damages.  Workers’ compensation policies normally don’t provide a defense for the separate actions.

Defending against claims outside of workers’ compensation in California is significantly different from handling a typical benefits claim.  Even if a workers’ compensation claim and a separate civil action proceed simultaneously, the employer’s workers’ compensation coverage is unlikely to provide a defense in the separate civil suit.

Because of the unique nature of these actions, employers facing claims under exceptions to workers’ compensation coverage need employer-focused counsel experienced in this narrow area.

Outliers from Traditional California Workers’ Compensation Defense

When workers’ compensation policies do not provide a defense to certain outliers, employers must find legal counsel on their own. 

For example, an employee who alleges serious and willful misconduct must demonstrate more than mere negligence by the employer.  To prevail, the conduct must be quasi-criminal in nature:  The employer must have acted with reckless disregard for human safety or with malice.

Allegations of serious and willful misconduct should not be taken lightly.  If proven, the Workers’ Compensation Appeals Board may increase an employee’s award by 50 percent.  In real dollars, this increase can be substantial because the calculation is based on the total amount of benefits and payments provided to the employee, including items such as indemnity benefits, medical benefits, medical-legal fees and rehabilitation costs.  Alternatively, an award can be reduced by 50 percent if the employee’s injuries are caused by his or her own serious and willful misconduct.

While the law prohibits employers from insuring against serious and willful misconduct, it allows employers to purchase insurance to defend against these types of lawsuits. 

Retaliation for Filing a Workers’ Compensation Claim is Prohibited

Employers may not discriminate or retaliate against an employee who has filed or plans to file a claim for workers’ compensation benefits.  Threatened or actual adverse employment action — termination, reduction of hours, demotion, change of work environment or duties, etc. — may serve as the basis for a California Labor Code Section 132a discrimination claim.

Successful employees can recover money damages, back pay, costs and expenses and, if applicable, reinstatement.  Insurance will not cover these awards, so the responsibility to pay lies with the employer.  Employers are also subject to fines and jail time — discriminating against an employee for filing a workers’ compensation benefits claim is a misdemeanor.

Why to Hire Susan A. Rodriguez as Your California Workers’ Compensation Defense Attorney

Employers dealing with workplace injury matter occasionally need counsel apart from their workers’ compensation insurer’s attorneys.  Susan A. Rodriguez has close to 30 years of experience successfully representing employers in California workers’ compensation defense and other matters.  No matter how big or small the employer and no matter how complicated or straightforward the case, Susan gives every client personal attention.  She and her team are results-driven and well-equipped to provide you with proficient, robust workers’ compensation defense.  To discuss your case with an accomplished employer workers’ compensation defense attorney in California, complete this convenient online contact form or call (213) 943-1323.

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Los Angeles, CA 90071

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Office: (213) 943-1323
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Los Angeles, CA 90071