Workers’ compensation is an insurance program that provides benefits to employees injured in the course of their employment.
Did you know that in 2024, the California workers’ compensation system remained stable after the pandemic? Premiums went up but the rates dropped moderately. The number of claims returned to the same amount as before the pandemic. Currently, the average costs for benefits and medical care keep increasing.
If you are wondering when workers’ comp starts paying in California, you need to understand that benefits usually begin after a waiting period, once your claim is accepted and the extent of your injury is verified.
A lack of legal counsel can make it difficult to determine what constitutes a work-related injury and how to file a workers’ compensation claim.
This article will answer some of the frequently asked questions about workers’ compensation.
What Is a Work-Related Injury in California?
California recognizes injuries sustained during working hours as work-related injuries. These include injuries sustained on the job site, during working hours, or while performing employment-related tasks.
Work-related injuries include slip-and-fall accidents, repetitive strain injuries, and driving incidents that happened while at work.
Sometimes, even stress-related conditions or illnesses that occur from your job can qualify as work-related injuries.
Understanding the definition of a work-related injury can help you manage your rights and responsibilities under California’s workers’ compensation laws.
How to File a Workers’ Compensation Claim
Filing a workers’ compensation claim in California involves several key steps that you must follow to protect your rights.
Report your injury to your employer as soon as possible, ideally within 30 days. Examine your injuries and seek medical attention if needed.
Your employer should provide you with a claim form, known as DWC 1, which you must complete and return. See to it that you fill out the form accurately to prevent any unnecessary delays in your workers’ compensation application. After submitting the form, your employer will notify their insurance carrier.
Keep copies of all documents for your records. You should follow up with the insurance provider to check the status of your claim.
If your claim is denied, you can appeal the decision. You can consult an attorney specializing in workers’ compensation to help you prepare and gather any additional evidence needed.
What Benefits Can Injured Workers Receive?
If your claim is approved after submission, you can expect to receive various benefits.
One of the benefits of having workers’ compensation is that you will be able to receive medical benefits for treatments related to your injury, such as doctor visits, surgeries, or physical therapy.
You can also receive temporary disability benefits if you can’t work during your recovery. The disability benefits will offset some of your lost wages, which were caused by your injury.
Permanent disability benefits are provided to workers who have sustained injuries that have rendered them permanently unable to perform tasks or work.
Vocational rehabilitation can assist you in finding new work if you’re unable to return to your previous job.
You might be entitled to supplemental job displacement benefits if your situation involves specific circumstances.
What Are the Responsibilities of Employers?
Employers are invaluable in the workers’ compensation process since they are primarily responsible for the creation of a safe work environment for their employees. They are legally obligated to help their employees with injury claims. Their main job is to keep the workplace safe by finding and reducing risks.
Employers should have workers’ compensation insurance to cover medical costs and lost wages for injured employees.
When an injury occurs, report it immediately and thoroughly, and assist employees with the claims process. Keep in touch with injured workers and inform them about their rights and the benefits they can receive.
Keep accurate records of workplace injuries and claims. Fulfilling these responsibilities helps protect your employees, create a positive work culture, and reduce financial risks for your business.
What Should You Do If Your Claim Is Denied?
If your claim is denied, you need to remain proactive and understand your options.
Examine the denial letter to determine the reasons for rejection. The reason will help you decide what to address and how to enhance the arguments for your appeal.
Gather all relevant documentation, such as medical records and witness statements, to strengthen your case.
File an appeal with the insurance company. Hiring a workers’ compensation attorney helps guarantee that your appeal will meet the specified time frame for the appeal application.
A workers’ compensation attorney can provide valuable guidance and support during the process.
Request a hearing with the Workers’ Compensation Appeals Board if your appeal is unsuccessful.
Staying informed and organized will improve your chances of a successful outcome.
