CALIFORNIA WORKERS' COMPENSATION

WORKERS' COMPENSATION

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what Workers' Compensation in California Means to You​

Workers’ compensation is an established social insurance program to provide employees prompt and effective medical treatment for industrial injuries or illnesses, no matter who is at fault. Thus, California employers are required by law to have workers’ compensation insurance, which provides medical care, temporary disability benefits, permanent disability benefits, supplemental job displacement benefits and/or death benefits.

Upon sustaining a work injury, you must notify your supervisor and be provided with a DWC-1 claim form from the Division of Workers’ Compensation. You must fill out the DWC-1 claim form and be sent to an industrial clinic by your employer. The medical legal physician may indicate your injury is work-related and has left you unable to perform your duties. At this juncture, the workers’ compensation insurance carrier should commence temporary disability benefits.

Workers' Rights from California Workers' Compensation

In California, injured workers have the right to comprehensive medical treatment. The law requires employers or the employers’ workers’ compensation insurance carrier to provide for any reasonable treatment for injuries suffered on the job. Employers’ are also responsible to compensate injured workers for compensable wage loss or temporary disability, permanent impairment and future medical care.
 
The medical treatment is paid entirely by the insurance carrier. You should not be forced to pay for any costs related to your work injury at any point of your workers’ compensation case. In the event you leave your future medical care open, the workers’ compensation insurance carrier will be responsible for future medical treatment.

California Workers' Compensation: Benefits

It is imperative to have someone advocate on your behalf to get your workers compensation claim filed with the Workers’ Compensation Appeals Board. We specialize in helping injured workers obtain benefits, medical treatment, and reach a settlement during their workers’ compensation claims. Our job is to plan an effective strategy for your case, gather evidence to support your claim, keep track of deadlines and represent you in hearings before a workers’ compensation judge at your local Workers’ Compensation Appeals Board office.

Medical Care If a Workers' Compensation Claim Is Denied

Unfortunately, a workers’ compensation insurance claim can be denied for a number of reasons. There are two main categories: procedural and medical. Types of procedural denials include:
 
  1. Time-barred claims – You have one year to file a California workers’ compensation claim, but must notify your employer within 30 days of the initial injury.
  2. Incomplete applications – If you have missed important information, you may have a claims’ examiner deny your application for benefits. They will argue that they cannot determine whether you are eligible.
 
There are also denials that come as a result of alleged medical determinations. They include:
 
  1. Injury not limiting work – A medical examiner may determine that the injury does not preclude you from continuing to work or that you were not disabled long enough for benefits to be paid out.
  2. Injury unrelated to work – An insurance company’s doctor may allege that while an injury exists, it did not occur as a result of you doing work but may have happened during your off-time.
 
There are other reasons behind denials, but these are the most common ones. While the law indicates that you receive up to $10,000 in medical care while your claim is being evaluated, it can be a struggle to obtain the other benefits you may deserve after an initial denial.
 
One reason to work with a workers’ compensation attorney with experience is their ability to litigate and advocate on your behalf. We may select a Qualified or Agreed Medical Evaluator who can examine your work injuries and provide recommendations regarding your medical care and disability.