How Does Workers’ Compensation Work in California?

California workers are entitled to prompt, effective medical treatment for any injuries or illnesses they suffer while on the job, regardless of who is at fault. The state workers’ compensation law also requires employers to pay essential benefits to injured employees who cannot immediately return to work.

To ensure injured employees have access to workers’ compensation, all employers are required under state law to carry workers’ compensation insurance. This mandate applies to any business that has employees, even if they only have a single employee.

What is Workers’ Compensation?

The U.S. workers’ compensation system is the country’s oldest social insurance program and has been adopted in most states, including California. Workers’ compensation insurance provides benefits to employees who suffer on-the-job injuries or certain work-related illnesses. These benefits usually take the form of payments for the employee’s medical care and compensation for lost income.

California’s workers’ compensation law provides for no-fault insurance policies that cover injuries related to employment. Unlike some states, California’s workers’ compensation law does not require that an employer be negligent or at fault to collect.

How Workers’ Comp Works for Employees in California

If you work in California and have been injured on the job, you will start the workers’ compensation process by filing a Workers’ Compensation Claim Form within one day of learning of your injury. Every employer must provide an injured worker with a copy of the form, so you should contact a workers’ compensation attorney if your employer refuses to do so.

After receiving the form, your employer will add additional information and submit the completed form to its workers’ compensation insurance provider. Your employer should also provide you with a copy of the form. The insurance company usually has 14 days to mail out a letter informing you of the status of your claim. If you file a form and your employer has not denied the claim within 90 days, the injury is presumed to be covered by workers’ compensation.

By law, your employer is required to authorize any appropriate medical treatment for your injuries within one day of your filing a claim. While your request for workers’ compensation is being considered, you can receive up to $10,000 in medical treatment. If your employer fails to pay your claim promptly, you may be entitled to increased payments.

If your claim is rejected, you have the right to appeal the decision to the Workers’ Compensation Appeals Board and ask that it review the determination. Should you choose to file an appeal, it is generally a good idea to hire a lawyer to represent you to protect your rights because your employer and its insurer will have lawyers arguing their side of the claim.

What Workers’ Compensation Benefits Can I Receive?

When are hurt on the job, the employer must pay for your initial medical care, even if you did not miss any work as a result. Additional benefits that are available include:

  • Paying the costs of ongoing treatment for the injury, including transportation expenses
  • Temporary disability payments for missed work
  • Permanent disability payments if you can no longer work
  • Vocational retraining if you can’t return to working with your previous employer
  • Death benefits for your dependents and spouse

Workers’ Compensation Settlements in California

Under California law a worker who has suffered an on-the-job injury can settle their claim with the insurance company. That is done by either agreeing to let the insurance company pay for all future medical care related to the injury, or taking a lump-sum payment equal to the cash value of any anticipated treatment. The settlements are referred to as either a “stipulation and award” or a “settlement and release.”

If you have a stipulation and award agreement you will enter into a relationship with the insurer to provide you with care for your injuries over the rest of your life. The agreement usually stipulates which injuries and body parts are covered, so you will not be covered for any medical issues unrelated to the workplace injury.

A compromise and release agreement will settle the case for one or more cash payments. While a compromise and release puts cash into your pocket, neither the insurer nor your employer will pay for any future medical care for your injuries.

Common Questions About California Workers’ Compensation

Who is exempt from workers’ compensation insurance?

Since any business with at least one employee must have workers’ compensation insurance in California, nearly all employers carry policies. However, the following are exempt:

  • Business owners with no employees (except roofers)
  • Some volunteers
  • Students participating in amateur sporting events
  • Officials for amateur sporting events
  • Domestic workers related to their employer
  • Deputy sheriffs and clerks
  • People who work for food, housing, or other benefits instead of pay

How is workers’ compensation calculated?

If you are injured on the job in California and are either temporarily or fully disabled, you are entitled to up to two-thirds of your pre-tax gross wage up to a maximum of $1,356.31 per week for injuries occurring after January 1, 2021. In most cases, you will not pay tax on your workers’ compensation benefits.

Who pays workers’ compensation in California?

In California every employer is required to purchase workers’ compensation insurance and, if an employee gets hurt, the insurance company will pay out the benefits to the injured individual. That means the state’s workers’ compensation benefits are financed by the business owners who paid for their policies.

Can my workers’ compensation settlement be garnished for child support?

If you owe child support and are hurt while on the job, you can contact your local district attorney’s office and request a support order modification. It is recommended that you do so right away so you do not accumulate any legal or financial penalties while you have no income.

When you receive a lump-sum workers’ compensation payment, California law permits the district attorney to take a portion of the settlement, including any unpaid child support for the period you were on disability.

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