SANTA CLARITA WORKERS COMPENSATION - INTERVIEW WITH ATTORNEY ROBERT CASTILLO

VIDEO TRANSCRIPT:

Robert Mansour:
All right, I think it's recording now. Hello everybody. This is Robert Mansour, and I am a lawyer in the Los Angeles County area, and today we have a special guest. His name is Robert Castillo, and he brought his excellent beard with him today. And Robert is one of my referral partners in his area of practice is workers' compensation, which often dovetails very closely to personal injury. And so I invited Robert today to be my special guest so that he can talk to us about workers' compensation law and educate us a little bit. So Robert, first of all, welcome.

Robert Castillo:
Thank you, Mr. Mansour, it's a pleasure to be here with you.

Robert Mansour:
Oh my God, please call me Rob. Mr. Mansour is my dad. So let's continue. So first of all, people call my office all the time about personal injury cases, but then I learned that they actually got hurt on the job or doing something while they're at work. Can you talk a little bit, Robert, about what's the difference between a standard personal injury case versus a workers' compensation case?

Robert Castillo:
Sure, sure. So personal injury can be anything from car accidents, slip and falls, things like that. And workers' compensation differs in the sense that you have to be working at the time of the injury. There has to be some connection to your employer as far as either furthering any type of employment relationship, something like that. So workers' comp deals with injuries that occur on the job.

Robert Mansour:
Okay. So let's say I am... I had a case about three years ago. My client was driving down the street. He was working for a pool company, so he's going to go service a swimming pool, and he's driving the swimming pool truck and he gets T-boned by a car that runs a red light and he ends up with a brain injury. Okay. So the question is, does he have two cases here? Does he have a workers' compensation case as well as a personal injury case? And can you explain why that would be?

Robert Castillo:
So assuming your hypothetical is that let's say that he was driving to service one pool and then going to a second location to service another pool. He was in the course and scope of employment. His job requires traveling and he would have to travel from one area to another. There are cases out there that talk about lunch breaks and stuff like that. But for the purposes of this example, yeah, he would have a claim against the driver who T-boned his car and he'd also have a workers' compensation claim.

Robert Mansour:
Okay. So I'm just going to go with the flow here with you, and this conversation will take us to some interesting places. But is there a problem of any sort, if the person is treating for, I'm sorry, if the person has a personal injury case against that person who ran a red light, but he's also receiving workers' compensation benefits, is the workers' compensation insurance company going to say, Hey, wait a minute, the guy who hit you is responsible for all of this and so we don't want to pay for it, or we want some kind of credit for all of the... Because had it not been for that bonehead who ran a red light, you wouldn't be here getting workers' compensation care from us. Do you follow what I'm saying?

Robert Castillo:
I do, and it can be quite confusing. So for purposes-

Robert Mansour:
... just basic, yeah.

Robert Castillo:
Yeah. For purposes of this conversation, yes, you hit the nail on the head with a credit. Workers' compensation is a no-fault system. So if he's injured at work, workers' comp benefits. Let's just assume-

Robert Mansour:
Whether he was at fault or not.

Robert Castillo:
Correct. Yeah, correct. There are some limited issues, but again, we don't have to get into that right now. If he's injured at work and he's driving, and let's say that he made a judgment call running a yellow light, whatever, or a red light, if he's injured at work, workers' comp. So the thing is that he can't double dip, this hypothetical injured worker. He can't double dip in the sense that there are no credits or it's all one pot. So there's not two separate pots where it's a PI case and a worker's comp case. It's all one event, it's one thing.

So if he's getting treatment through the workers' comp system, normally in a PI case, I believe a personal injury attorney will send them to doctors or to chiro's or to whoever it is that the injured party requires. But normally what happens with the workers' comp case is that they see the workers' comp doctors. And then later down the line when the parties settle, there's credits depending on who settles their claim first. The biggest takeaway to take from that for people who are listening to this, is the injured worker's attorney and the injured worker's personal injury attorney need to work very closely together to get maximum benefits for the client.

Robert Mansour:
So basically the takeaway is that if you have a personal injury case that is going on at the same time as the workers' compensation case and they are connected in some way or they involve similar body parts or whatever, you need to be mindful of that and make sure the lawyers are working together?

Robert Castillo:
You're right. And while it's primarily that the injury itself stems from the same incident.

Robert Mansour:
Oh, from the same incident, okay, I got you. Okay, very good. So now this is interesting, because you mentioned going to the workers' compensation doctors. So let's say our hypothetical guy, the pool guy, he was doing his work, he got hurt while he was on the job. Can he go to any doctor that he wants or does he have to go through certain doctors prescribed by the workers' compensation insurance company?

Robert Castillo:
Sure, sure. Well, first thing that I tell clients, my clients, you can always treat with your doctors. You can always go to your doctors and ask for treatment. The thing is that an insurance company most likely will not pay for it. Now, there is a way to pre-designate doctors prior to any type of injuries. There's some specific rules regarding that. But again, let's assume that this hypothetical guy did not have a pre-designated doctor or anything like that. So what he will have to do is treat in the employer's medical provider network. So you can't see any doctor you want to.

Number one, one of the biggest issues is whether or not a doctor will be willing to take your case. I've had situations where cases were either too old. I've had situations where doctors will only treat specific body parts, maybe they specialize, they're a spine specialist, and this involves upper extremities or lower extremities. So it can be very difficult to find doctors, but that's where a benefit of having an attorney comes in is we know which ones, at least the reputable attorneys, we know which ones to send you to and which ones not to send you to.

Robert Mansour:
So go ahead. Please go ahead.

Robert Castillo:
Well, so yeah, I was going to say, you can always treat with your doctors. Some of the problems that you run into though. Number one, the insurance company won't pay for it. So if you have co-pays or if you have things that you have to pay for, that's going to come out-of-pocket. The other thing is sometimes what happens with private physicians, with doctors through your own private network, sometimes what happens is you tell them, I was working and I was injured. And when they hear that, they say, you need to go to your worker's comp doctors. They will stop seeing you because they're afraid. Yeah, they're afraid of who's going to pay them and they don't want to get in trouble with their insurance company or whoever's running their business. So a lot of times they'll say, I can't treat you for this. And that sometimes becomes frustrating for the injured worker as well.

Robert Mansour:
Okay. So now let's back up a little bit. So I'm an injured worker, I got injured on the job. What should be my first course of business? Should I call a lawyer right away or should I call my employer and tell my employer what happened, or do I... I'm not sure what my first step should be.

Robert Castillo:
Yeah, again, let's say that you were working in an office and you tripped and fell and you hurt your knees, maybe you hurt your back, you fell backwards or something. You should immediately tell your employer. And if it's a situation where you feel like you need to see a doctor right away, you should tell them ASAP and you should tell your employer, your manager, whoever it is, I need to see a doctor. This just happened. Most of the time, these companies, employers, insurance companies will have industrial clinics they'll send you to, and they're urgent cares that you can go to to get checked out.

Robert Mansour:
Okay, now do they open a claim for me or do I have to do that myself? Do I call HR? What administratively should I be doing after that?

Robert Castillo:
So employers are supposed to provide a claim form for the injured worker. You can request the claim form as well. You can easily find it online too. Some employers, again, I'm generalizing here, some don't really know the procedure and they're a little ignorant of what's supposed to happen. So it is what it is. But they're supposed to provide you a claim form, and that's really what starts the worker's process. It's a DWC-I form, and it's a pretty straightforward, how did you get hurt, what body parts did you injure? And there's a portion for the injured worker, and there's a portion for the employer which then gets sent to the employer's insurance company.

Robert Mansour:
Okay, so I'm getting care now. I'm going to the worker's compensation doctor because my employer hooked me up with this clinic and my care, let's say my care is going pretty good, but I'm not getting better or whatever the case may be. At what point do I involve a lawyer, or maybe I just don't involve a lawyer at all? How do I know when to involve a lawyer?

Robert Castillo:
Well, so I'm going to have to give you a lawyer answer on that, it depends.

Robert Mansour:
Expected at least one lawyer answer today.

Robert Castillo:
Yeah. No, it depends. I would say that in a situation where... Well, let me put it this way. Let me put it this way. When people call me, it's usually because they're not getting callbacks from the adjuster or they need to see a specialist. Let's go back to the slip and fall at your office. If their treating doctor says you need to see a spine specialist and they're referring you out for a spine specialist, sometimes adjusters won't take any action on the file. There needs to be authorization to this new doctor. Sometimes they'll do it, sometimes they won't. But these adjusters probably have 30 files sitting on their desk that need to be worked on, and maybe there's another 10 or 11 coming in or whatever. They may be overworked, I don't know. But sometimes they aren't doing their job. So normally when people call me, it's because adjusters are not doing their job. So something needs to happen, something's not happening. And so what can I do about this?

There are situations, there are times where you don't necessarily have to have an attorney if you're getting good care, if you're getting paid the temporary disability, which is two-thirds of your average weekly wage while you're off of work, other than maybe changing your doctor or if situations come up or if you want someone to run the file to make sure it runs correctly, that might be the time to contact an attorney. Most attorneys will give you a free consultation or assessment of your claim. And if it's something where you feel someone needs to get involved, make the appointment and see the attorney.

Robert Mansour:
And there's really no harm in talking with a lawyer and the lawyer, as long as they're an honest lawyer, they'll let you know whether or not you would really benefit from them helping you, helping them or not. You would be honest with them and say, Hey, sounds like everything's going fine. You're doing good on your own. You don't really need a lawyer. You would tell them one way or the other.

Robert Castillo:
Yeah. I've actually had a situation where I told someone, I don't think you really need an attorney right now. And they called me back a year or two later saying, Hey, can I hire you now because something came up? And you were the only one that told me I didn't need an attorney at the time, so now I think I need one. So I think honesty is always the best policy. But again, so what I'll also say is I've had people tell me they've been intimidated to call lawyers or attorneys because it can be, especially if it's your first time, it can be an intimidating process. And I hope this shows that attorneys are people just like everyone else. And assuming that the attorney is there to help you, that's why I became an attorney is because I wanted to help people. So I would say don't be afraid to call and reach out and just let them know what's going on.

Robert Mansour:
Okay. So it's interesting. We talked about the medical care that is available to the injured person. What else is available to them? What other benefits are available to... Is it just the medical care and that's pretty much it? Or is there anything else that they get by going through the system?

Robert Castillo:
Well, the medical care I think is one of the biggest things. But if the injured worker is unavailable to return to work or if there's work restrictions such that the employer can't bring them back to work, then they could be entitled to temporary disability, which you can think of that as lost wages. And that, as I mentioned earlier, it's two thirds of whatever your average weekly wage is.

Robert Mansour:
Who pays that? The government?

Robert Castillo:
That's paid by the insurance company. The insurance company who represents your employer will issue you checks every two weeks.

Robert Mansour:
So what if I say, I don't want two thirds, I want all of it. I want 100%. Why am I getting two thirds?

Robert Castillo:
That is the law. So it would be nice. The idea behind it is it's supposed to reflect a similar amount as to what you would normally be receiving. So it's not taxed or anything like that. It's supposed to reflect the taxes and things like that. So the other thing also is that I think public policy would state that you shouldn't be making more or the same as what you would be working versus not working. That's probably not a good thing.

Robert Mansour:
I understand. Okay, so let's say I do get a lawyer on board and the lawyer helps me. And let's say I get to the point where either I am fine, I'm feeling much better, or maybe I'm not a 100%, maybe I'm 80%, 75% of where I used to be. What does the lawyer do at that point in the case?

Robert Castillo:
Well, so one thing I tell clients is if your question to me has anything to do with a medical question, then I'm deferring that to the doctor. Okay. As you know, Mr. Mansour, Rob, we are doctors of law technically, but we're not medical doctors, so we can't make any of those determinations. So you'll have to talk to your medical doctor about what any situation is going on. Let's assume that, let's talk about that pool guy. Let's say that maybe the doctor's requesting some surgery and the pool guy is saying, you know what? I don't think I want to have surgery. I'm scared to go under the knife. That's not really for me. And I'll live with the pain in my, let's say it's a shoulder surgery or something. I'll live with the pain. At a certain point, doctors are going to say, you know what? Then there's nothing left for me to do on an orthopedic level. Really, it's going to be monitoring you on a regular basis, and this is what you're going to have to live with.

So at a certain point, an injured worker will become what we call permanent and stationary, which just means that they're not anticipated to get any better or any worse. It's something that they're going to have to live with. And at that point we talk about something called permanent disability. Now remember, there's temporary disability, which is lost wages, and then there's permanent disability. Okay. So at that point, we want to make sure, to answer your question, the attorney will want to make sure that all the body parts are discussed and that we have final reports from both the treating doctor and there most likely will also be a QME or a qualified medical examiner. They're like an independent state doctor. And again, we want to make sure that all the reports are final, that all the body parts are discussed, that there's nothing missing or anything like that, so that we can talk to the client about possible settlement.

Robert Mansour:
So before we get to settlement, what if I don't agree with the qualified medical examiner or I don't agree with my doctor, I have a different opinion. Can I appeal that? And who decides that?

Robert Castillo:
Well, ideally you can disagree I think with the doctor, you could disagree with a QME by talking to your PTP, I'm sorry, the QME, the qualified medical examiner and the primary treating physician, the PTP. If let's say that the QME state doctor gives you a conservative report, oh, he's not that bad or whatever, then you could talk to your PTP about it. But really it's how they see you. It's how they view you as far as medically. So maybe doctors will disagree, but it really comes down to what the medical reporting is saying. And assuming that it's substantial medical evidence, meaning that everything has met the qualifications, this is what the doctor thinks.

Robert Mansour:
So we can't go doctor shopping and find another doctor who says something different. So speaking of which, do you as the lawyer, if you're my lawyer, do you have any say or do I have any say in who this qualified medical examiner is going to be or do we just the luck of the draw?

Robert Castillo:
So the way that the process works is, let's just say it's reached a point where we need to get a qualified medical examiner, QME. There will be a panel of three doctors that is sent to the attorney, and the applicant's attorney will get to strike one name off of the list. The either insurance company or defense counsel will get to strike another name, and then you're left with whoever's on that list. There are times where the applicant's attorney and the defense attorney will agree on a doctor, and that's an agreed medical evaluator, and usually they're very straight shooters. It's something that is best for the case.

Robert Mansour:
Okay, good. Okay. So now let's say that either I have a residual problem and it's time to settle the case, or I don't have a residual problem and it's time to settle the case. What does the applicant, the injured party, I think when you said applicant, I'm assuming that's the injured party.

Robert Castillo:
Yes-

Robert Mansour:
What does the applicant get out of the settlement? What are some of the options that are available to an applicant? In a personal injury case, they get money. There's a settlement. The lawyer takes a piece of the settlement. Any outstanding medical bills have to get paid and the rest of the money goes to the injury victim, the plaintiff, in my case, we don't call them applicants, we call them the plaintiff or the claimant. In your particular situation, what does the injured party get after all is said and done?

Robert Castillo:
So assuming that there was no issues with the temporary disability, the lost wages, sometimes there's retro periods or there's overpayments, but let's assume none of that exists in this hypothetical. If there is any disability or permanent disability, then again, the parties need to come together and assume and put together what the disability is. A QME and a treating physician may have a different number, and that's again where you talk settlement, settlement is giving something up, but getting something in return. And so the permanent disability is on a scale from one to 99%, and depending on where you land on that scale, that is the value of your case. So there's also two ways to settle your case. You can settle your claim via stipulation with requests for award. And a stipulation will agree to a percentage of disability, and you'll keep future medical care open going forward.

So let's just say someone trips and falls on their knee. Maybe they have a surgery on their knee. At a certain point they become permanent and stationary, you get a rating and the rating will equal the permanent disability, and then you decide to do a stipulation. You'll have future medical care on your knee going forward. The other way you can settle your case is something called a Compromise and Release. A Compromise and Release is a buyout of your claim. It essentially means that you can no longer treat through the insurance company's medical provider network. The claim is closed and you're on your own going forward.

There's a lot of nuances, but basically the parties have to agree on a Compromise and Release. You can't go to court and have a judge order that. A judge can approve an order that for a Compromise and Release. In fact, they have to, but they... Sorry, let me reword that. Any settlement in workers' comp has to be approved by a judge. They don't have to approve and order for a Compromise and Release. They have to deem it adequate in order for them to approve that. So I just want to make sure there's no confusion there. But anyways, anyway, a Compromise and Release that has to be by an agreement between the parties.

Robert Mansour:
So just let me dumb it down for my purposes so I really understand. It sounds to me like if I'm the applicant and I got a residual problem, I can say, Hey, listen, I want future medical care. I want to be able to go to these doctors anytime I need to in the future or in exchange for some more money, I close that door and I say, I'm not going to pursue any more medical care, I'm on my own. In exchange would I traditionally get more money as a result of that agreement or not necessarily?

Robert Castillo:
Potentially.

Robert Mansour:
Potentially.

Robert Castillo:
Yeah. Yeah, because when you buy out your claim, you're looking at the permanent disability and you're looking at what potential future medical care there might be. Remember that applicants, injured workers, and defendants, the insurance companies are going to value that claim differently. And the idea is that there's a meeting of the mind as far as, okay, we think that this works for us and, yeah, that works for us too. So I don't want to make it seem like it's a... There's a lot of nuances that go into it.

Robert Mansour:
Or negotiation, right? It's negotiation.

Robert Castillo:
Yeah. Negotiations. There's some other things that go into it as well. And again, you should talk to your attorney about the right time to settle. Things could always come up. And again, every case is different, but let's just say it's the end of the case and it's time to discuss what kind of settlement you're going to do. Really as an injured worker, what you need to ask your attorney is, well, not even ask, what you need to tell them is what you want. What I like to tell my clients is, you are running the ship, you're the captain of the ship, I'll tell you which way you can go and I'll tell you the consequences of those actions. But ultimately you decide. One thing that almost every client asks me is, what do you think I should do? And I will tell them the same thing. This is really your decision. You need to tell me what you want to do because when I'm done working on one file, I close it up and I work on my next one.
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For them, for the injured worker or for the P.I client or claimant, whatever, that's affecting their life going forward. So they really need to understand the choices that they're making and what they want to do going forward.

Robert Mansour:
So last question, Robert, and I appreciate your time today, and this has been really educational, I would imagine not only for somebody watching this video, but for me personally, even though I've been a lawyer for 30 years, I don't practice this area. So this is really helpful. Last question is how do you make money? I know you want to help people and everything, but after all, you got a family, you have a business to run. How does the lawyer get paid?

Robert Castillo:
So workers' comp attorneys work on something called contingency fees, similar to P.I cases, and our fees are set right now at 15%, one, five. So at the end of the day, whatever your case settles for, it's 15% of that.

Robert Mansour:
I understand.

Robert Castillo:
Yeah. And that's pretty standard in the workers' comp community. So whatever attorney you contact. I've heard some rumblings that there are some attorneys out there asking for 18%. Right now I'm set at 15. That seems to be the industry standard. So until there's any changes, that's the fee going forward.

Robert Mansour:
Well, it sounds to me like it's certainly worth it to have somebody with you guiding you, helping you make decisions throughout the process. So Robert Castillo is my colleague here, my referral partner. Work comp cases, I always refer them to Robert. He's a wealth of information and on top of that, he's ethical, he's compassionate, and he's very easy to talk to. So Robert, thank you so much for joining us today. I'm going to try to stop the recording. Is there anything you want to add that we haven't touched upon yet?

Robert Castillo:
No, the only thing I would say is, Rob, to add on to your point, don't be afraid to call attorneys, whether it's me or any attorney. Again, we're for the most part here to help. And so that's the biggest thing that I've noticed is that people get intimidated and they don't want to talk to attorneys or maybe they had a bad experience with an attorney. Not all of us are bad, okay. And not all of us have bad personalities or whatever. We get stressed out just like everyone else, but for the most part, we're here to help. And don't be afraid to contact an attorney.

Robert Mansour:
Absolutely. Fantastic, Robert. Thank you. I'm going to try to stop the recording. Let me see if I can do it right.

Robert Castillo:
Okay.
​Robert Mansour can help advise you regarding your work injury case.  He serves the entire Santa Clarita Valley including Valencia, Canyon Country, Saugus, Newhall, Castaic, Stevenson Ranch, and surrounding communities. Call Santa Clarita personal injury attorney Robert Mansour at (661) 414-7100 for a free consultation and evaluation of your case.  You can also fill out our Free Case Evaluation form.

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