In California, workers’ compensation claims can be split into two broad categories: 1) Specific industry and 2) Cumulative trauma. Under Cal. Labor Code § 3208.1(b), cumulative trauma is harm “occurring as repetitive mentally or physically traumatic activities extending over a period of time, the combined effect of which causes any disability or need for medical treatment.”
Notably, cumulative trauma claims can be especially complicated. Disputes can arise for several different reasons. This raises an important question: When should an employer/insurer settle a cumulative trauma claim? The answer is “it depends.” Here, our Pasadena workers’ compensation defense lawyer discusses key considerations for setting cumulative trauma claims in California.
Always Carefully Investigate the Matter—Gather Medical Records
Whether or not it is advisable to settle a cumulative trauma claim always depends on the specific circumstances of the case. Before a final decision can be made, an employer/insurer needs to have all of the information—from relevant vocational records to medical documentation from the employee. A thorough, proactive investigation can make the difference.
After gathering medical records, it is best practice for employers to scrutinize these documents for details about the injury’s onset, its progression, and its current status. A worker is entitled to workers’ compensation benefits for cumulative trauma only if a job-related cause can be established. Employers should pay attention to any pre-existing conditions that might have been aggravated by workplace activities.
Consider the Potential Cost of a Dispute (Medical Review, Litigation, etc.)
In California, cumulative trauma workers’ compensation claims are far more likely to end up in litigation than specific injury workers’ compensation claims. Understanding the financial implications of a dispute is vital. Consider the costs associated with medical reviews, potential litigation, and other related expenses. Often, the expenses of defending a claim can escalate quickly.
The cost of handling a dispute can rise especially rapidly if extensive medical evaluations are required or if the cumulative trauma case ends up in litigation. Employers and insurers should factor in the possibility of prolonged court proceedings, attorney fees, and the costs associated with potential appeals. Evaluating these costs upfront can provide a clearer picture.
Conduct a Comprehensive Cost-Benefit Analysis
A comprehensive cost-benefit analysis is at the foundation of making an informed decision on settling a cumulative trauma claim. To be clear, the analysis should not only include the financial aspects but also consider the potential impact on the company’s reputation and employee relations.
A well-rounded analysis will help in determining whether the benefits of settling the claim outweigh the costs, thereby guiding you toward a decision on settlement. You do not have to evaluate settlement negotiations on your own. An experienced workers’ compensation defense attorney can help.
Speak to a Workers’ Compensation Defense Lawyer in California
At Yrulegui & Roberts, our Pasadena workers’ compensation defense lawyers have considerable experience handling complex cumulative trauma claims. If you have any questions about settling these cases, we are here as a legal resource that you can trust. For a completely confidential review and evaluation of your case, please do not hesitate to contact us today. We provide workers’ compensation defense representation in Pasadena, Los Angeles County, and throughout the wider region.
