Scaffolding collapsed on remodel job, but employer had no insurance?

by David
(San Leandro, CA)

I was working with a homeowner on a remodel for almost a year. On 6/26/2014, the scaffolding I was on collapsed, causing me to fall 20+ feet to the ground. On the way down, my foot got caught in the ladder, injuring my foot and ankle. I was taken by ambulance to the ER.

I tried to reach my employer during the 5 days I was in the hospital, but was ignored. I then filed my claim of injury. No reply. I tried certified mail, but he did not answer the door, nor pick up the article at the post office. I filed a claim with workers' compensation, who verified my employer had no coverage.

I also requested benefits from the Uninsured Employers Benefits Trust Fund (UEBTF) for my injuries. The day of my hearing (04/14/2015) I was approached by an insurance rep saying she represented my employer (Homeowners policy and also WC) and that it wasn't necessary to have the hearing, as she agrees with my claim, agrees I was hurt on job. She said all I need to do is a deposition for her, then I'd get paid.

She also suggested I hire an attorney to get MORE money. The hearing was cancelled, and what has happened since then is an absolute JOKE. I have had several surgeries on my foot/ankle, am in extreme pain daily, and now walk with a cane and limp. The doctor who performed two surgeries so far said I will never work construction again.

I was deposed, was made to see the Insurance company's doctor. The entire time my employer tried to deny I ever worked there. The result of this was that they agreed with what my records already stated was wrong with my foot/ankle due to the fall at work.

The doctor now wants to do more surgery/fuse ankle, which I know will make walking more difficult than it is now. I DID hire an attorney, but not a great one. He told me to come meet with him to discuss settlement and what I want. All this, and I have never seen a dime in weekly WC benefits?

My question: Since the WCAB did not hear my case, and the insurer wants to settle, wouldn't I be better off filing a personal injury lawsuit? And what could I have done to have been receiving weekly benefits since I was hurt? Employer has not paid a single medical bill - thank god for my health insurance taking care of it all. I'm just not sure what to do now? Thank you for any perspective you can give.

Visitor Question:
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ANSWER for "Scaffolding collapsed on remodel job, but employer had no insurance?":

David (San Leandro, CA):

It is our policy not to interfere with the attorney-client relationship. To do so would be entirely inappropriate. Your interests would be best served by heeding the advice and counsel of your attorney. If you aren't satisfied with the advice and counsel of your attorney, you have the right to seek a second opinion.

Under Section 3700.5 of the California Code, it is a misdemeanor for an employer not to have workers' compensation insurance. This is true even if the employer has only one employee.

The maximum penalty for an employer who fails to carry workers compensation is up to one (1) year in the county jail, a fine of not less than $10,000, or both. Additionally, the employer would be legally required to pay the injured worker's medical and therapy bills, out of pocket expenses related to the injury and treatment, and about 2/3rds of the worker's lost wages.

However, in most cases, when an injured worker relies on his or her own medical insurance, and that insured later receives workers' compensation benefits or other compensation covering the same amount of medical bills, the insured’s medical insurance company has a right to be reimbursed for the monies they already paid to the insured.

Best of luck,

Judge Calisi

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by: David

Maybe I did not ask the right question. The day I fell, I was the only person working and had to drag myself thru the fallen scaffolding and debris to get to my cell phone and call 911. Ambulance took me to nearest ER. Due to employer not responding to my urgent msgs. I HAD to be treated immediately, and had to use my own insurance. I'd have no problem reimbursing my Insurance Co.

I am just confused as to why my "CASE" is even STILL being considered a Worker's Comp case, as it has not moved thru the WC System as it should have. I have not rec'd any weekly benefits from WC, and was convinced I would need to do nothing more than provide my deposition to be done with my case. THIS is not what happened.

A year later now, I am still going back and forth with the lady from the hallway (she is an Attorney, not Ins. Rep.) Now I have another letter (Corrected Notice - DENIAL) from State Farm stating there is now a factual dispute re: the location and mechanism of my injury.

The "denial language" based on coverage investigation and lack of cooperation are being removed, since "Coverage has been extended and my deposition has been taken."

Not sure what "coverage has been extended" means, but feel like I am just getting the run around from all involved because the statue of limitations is coming soon (6/27/2016) at which point I will have no other choice but to accept whatever they MAY offer, if anything.

Maybe I should be going back to the WCAB for help with this? And finally, how would I get employer in to court on the misdemeanor?(3700.5)

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