From the beaches of Malibu and La Jolla to the peaks of the Sierra Nevada Mountains and everything in between, it's no wonder so many people want to live and work in California. But while you probably have no trouble planning your weekends, most of your time is spent at that 9-to-5. With so much time spent at work, there is ample opportunity to be injured. That's why employers purchase workers' compensation insurance, which covers employment-related injuries and illnesses regardless of fault, but can also prohibit you from filing a lawsuit against your employer in most cases.
Whether it's an injured neck from a fall, or a hurt shoulder from repetitive motion, if you've suffered a work-related injury in California, you'll need to know the benefits and requirements for filing a workers' compensation claim.
The table below shows key aspects of California's workers' compensation laws, including the types of benefits and important deadlines.
|Types of Benefits||
What Should I Do If I've Been Injured?
If you've been injured, you should first seek emergency medical attention (if necessary), or go to either an approved medical provider or your predesignated physician and tell them that your injury or illness is job-related. Additionally, you must give signed, written notice of your injury to your employer within 30 days or risk losing your right to receive any benefits.
Your employer then has one day to give or send you a claim form, but you can also find the workers' compensation form online. You generally have one year to submit your claim form back to the employer, and you should do so in person or by certified mail.
What Happens After I File My Claim?
In keeping with the strict timelines, the employer or claim administrator must authorize appropriate medical treatment within one day of receiving the claim form. The employee may receive up to $10,000 in medical treatment while the insurance company decides whether to approve the employee's claim. If the claim is not denied within 90 days, the injury is presumed to be covered.
What Should I Do if My Claim Is Denied?
If your claim is denied, you have the right to have your case heard by a judge. You must file an Application for Adjudication of Claim with required documents, give notice to the other parties, and file a Declaration of Readiness to Proceed. Your case will be scheduled for a mandatory settlement conference and if the case is not settled there, you will have to prepare documents describing the dispute, identifying what you will present at trial, and give the names of witnesses who will testify. An attorney can help you prepare the appropriate documents, file on time, and represent you in front of the administrative law judge. If you disagree with the judge's decision after this trial, you may file a Petition for Reconsideration.
Injured and Feeling Lost? Receive a Free Claim Review
Workers' compensation claims are fraught with tight deadlines and strict requirements, but are crucial to the recovery process after a work-related injury. Learn more about these requirements and the strength of your claim by receiving a free claim evaluation from an experienced, local attorney who is familiar with California workers' compensation laws.
Contact a qualified attorney.