How to file a workers’ compensation claim in California?

How workers' compensation claim

How to file a workers’ compensation claim in California? Work injuries are far more common than you might imagine, but that doesn’t mean they’re easy to deal handle. After getting injured on the job, you’re likely to face one of the most challenging times of your life. Depending on the severity of your injuries, it may take you several months to recover. Plus, you may have to pay hefty medical bills. But if you can’t work while you rehabilitate, how will you meet these expenses?

Fortunately, workers’ compensation benefits are here to help. Through them, you can receive payments that will help fund your medical treatment and cover some of your lost wages during your recovery. However, obtaining these benefits in California is often more complicated than it seems.

Here is a step-by-step guide to filing a workers’ compensation claim in California after a work-related injury.

Special considerations for California

Each state differs in terms of workers’ compensation. If you are a California worker, you should be aware of the following:

  •       Mandatory insurance: All California employers must carry workers’ compensation insurance to guarantee benefits for their employees.
  •       Only work-related injuries qualify: Employees may only be compensated for injuries that occurred within the scope of their employment.
  •       It’s a no-fault system: Even if you were responsible for your injury, you could still apply for compensation. Cases of extreme negligence or misconduct are excepted.
  •       Exclusive remedy: Workers’ compensation is the only legal remedy by which you can recover damages after a work-related injury.

Do you need an attorney?

After a work-related injury, you may wonder if you should hire a Los Angeles workers’ compensation lawyer to get the settlement you need. In theory, you could handle your claim on your own. However, if you suffered severe injuries or if your claim is denied, working with an attorney might help. A legal professional can increase your chances of receiving the maximum possible compensation for your case.

If you want to find out how a lawyer can help you, consider calling a workers’ compensation law firm, such as C&B Law Group, for a free consultation. These attorneys are ready to answer all of your questions and help you with everything you need.

Step 1: Get medical attention

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After a work-related injury, getting the medical care you need should be your priority. Don’t waste time; go to the doctor as soon as you can. Your treating physician will evaluate and treat your injuries. Plus, he/she will also issue a medical report that will significantly affect the value of your claim.

Step 2: Report the injury to your employer

Next, be sure to notify your employer of your injury correctly. The notice should be in writing and must be signed by the employee or someone acting on their behalf.

Under California law, you have up to 30 days to notify your employer of your injury. If you fail to report your injury within this time, you may lose the opportunity to receive the compensation you need.

Step 3: File the claim

After reporting your injury, your employer will have to submit a claim form to you, called a DWC1. Be sure to fill out this claim as soon as you can and return it to your employer.

Subsequently, your employer will file your claim with the insurance company. An adjuster from the insurer will contact you to obtain additional information, such as your medical records and rehabilitation costs.

At this point, you should contact a local workers’ compensation attorney to help you deal with the insurance company moving forward.

Step 4: Insurer approves or denies your claim

Once your claim is filed, you will have to wait for the insurance company’s decision. The insurer will evaluate the situation and decide whether to approve your claim or deny it.

In case your claim is approved, the insurance company will send you a settlement offer. You are then free to accept this offer or renegotiate it. Generally, confronting an insurance company on your own is usually a bad idea. Therefore, working with a Los Angeles workers’ compensation attorney might help. The attorney will aggressively negotiate on your behalf to maximize your benefits.

On the other hand, if your claim is denied, you may appeal the decision.

Step 5: Appeal the decision if needed

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When your claim is denied, you will need to act quickly to reverse that decision. First of all, get the legal assistance of an attorney before proceeding. Next, you will need to request a hearing before the Workers’ Compensation Appeals Board (WCAB). These hearings are similar to court trials but without a jury. The judge will evaluate the situation and render a verdict based on the available evidence.

Step 6: Get your settlement and return to work

After getting fair compensation with the help of your attorney, you will be able to pay your medical expenses and focus on your recovery. Once you are sufficiently recovered to return to work, you will no longer receive wage replacement benefits and can return to your everyday life. However, if you suffered permanent injuries, the insurance company may be required to pay additional benefits. 

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