I travel from to store to store to do my job....I was done with my assignment at store ,I bought a soda on my way out and was headed to the restroom when I slipped and fell in a puddle of water. Mind you I had not left the Store Yet. My work is telling me that it is a Personal Injury do to the fact once I made a purchase at the store I took myself of the clock... is this true ? I live in California I have been on State disability for 12 weeks and have exhausted my FML as I went along with there decision. In talking to a Insurance adjuster for Workers comp. she is telling me it should have never been a Personal Injury..Please Verify
There are two potential claims here, a workers' compensation claim under your employer's workers' compensation insurance, and a "third party liability" claim against the store or premises owner where you fell. These claims proceed simultanouesly and interact with each other. This can be a complicated process, so you should talk to both a workers' compensation attorney and a personal injury attorney about your rights. Sometimes the same attorney can handle both.
In general, workers' compensation will cover your medical expenses and temporary disability (lost income) while you are not working. Later, when your primary care doctor declares that you are "permanent and stationary" in your medical condition, you may be entitled to a "permanent disability" award and some provision for future medical expenses.
This is separate from your liability claim. That claim will be for past and future medical expenses, lost income and pain and suffering. Obviously, some of what you are claiming may have been paid by workers' compensation and the workers compensation carrier has a right of reimbursement, or a "lien", for the amounts it paid out in the workers' compensation claim.
There are a lot of nuances in the interaction of these claims and it would be impossible to cover all the variables here. You have two claims with separate rights in each claim. You should get a free consultation with an attorney or attorneys knowledgeable in both areas as soon as possible. There are statutes of limitation that apply and require that you take legal action within a prescribed period of time.
HUGE PROBLEM; what if the puddle was found NOT to be the result of anything the store owner did wrong? If the store owner was not negligent, you get absolutely nothing.
The Insurance Adjuster is correct. FILE YOUR CLAIM FORM FOR WORKERS COMPENSATION BENEFITS IMMEDIATELY... you can get Workers Comp benefits even if you are "off the clock" in many circumstances...like using a rest room away from the workplace!
You got your Legal Advice from your Employer...always generally a really bad idea.
Employer's benefit from an employee obtaining 'personal comfort' like liquids and bathroom breaks on their 'special mission'...so this is covered by workers comp, just be ready to prove this at trial as there is the chance the adjuster can deny the claim (because the employer wants the chance to convince a judge that your soda purchase was a 'detour'...ridculous, but they can assert this at trial...then LOSE).
GET A CERTIFIED SPECIALIST WORKERS COMP ATTORNEY today. Certified Specialists pass an extra Bar Exam just in Comp laws and they cost exactly the same as non-specialists who don't do all the conintuing education on the new comp law.
I'll try to put in the link to certified specialists in workers comp in the central valley area.
NEVER HIRE AN ATTORNEY who sends some kid to your house to have you sign blank forms!
meet with the attorney and get the attorney's game plan before you sign to be represented!
Then you'll know if the attorney is clueless and having a legal secretary practice Comp without a license.
THIS SAID...it's possible the store owner should have done something about that puddle and you ALSO have a NEGLIGENCE claim against the store owner... you have two years to pursue this, and any award in Workers Comp would be deducted from the civil court award (or settlement).
It's possible one firm could represent you on both claims but!!!!! an attorney gets 33-40 % of the personal injury money, but only 15% of your comp money.
THIS gives the attorney 'incentive' to get a small comp award and a bigger Personal INjury award, which gets you LESS...lookie:
LOSSES IN LOST WAGES, EARNING CAPACITY, PERMANENT DISABILITY = $50,000
Comp Settlement @ $40,000 = $6000 to Comp Attorney, $34,000 to you
Pers.Inj. Sttlmnt @ 10,0000 = $3333 to PI Attorney, $6,667 to you = $40,667 net to you
Comp Settlement @ $20,000 = $3,000 to comp attorney, $17,000 to you
Pers.Inj. Sttlmnt @ $30,000 = $10,000 to PI Attorney, $20,000 to you = $37,000 net to you
Which looks better ??!! Sadly, the attorneys never show this to the client!
NOW: GO TO A FREE SEMINAR at your local Workers Comp board so you get familiar with all these crazy terms and hear some of the rules.
If you are on a work related job or running an errand on behalf of your employer at the time of the fall you have a workers compensation claim.The employer must pay you temporary disability to compensate your time off work. However there are several medical and disability technicalities when you make a workers compensation claim. An attorney may be necessary if you have substantial injuries.
If the water puddle was there over 30 minutes( generally speaking) and if there is no protocol for sweeping/ inspecting the floors you may have a valid personal injury claim against the store.
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