Workers’ Compensation Claims Process in California – Step by Step

Oct 13, 2022 | Workers Compensation

The workers’ compensation laws of California aim to provide economic relief and job security to injured workers while helping employers avoid civil liability for their employees’ workplace injuries. State law requires every employer in the state with at least one employee to have workers’ compensation insurance. Some workers are exempt, such as independent contractors who are not fully employed, domestic care workers, and federal employees working in the state. In addition, all non-exempt employees have the right to file claims for workers’ compensation benefits after sustaining injuries at work.

If you or a loved one recently suffered any type of workplace injury, it’s vital to know the state’s laws pertaining to your recovery options and what you can expect in the workers’ compensation claim filing process. Depending on the nature and cause of your injury, you could also have grounds for further legal action beyond a workers’ compensation claim. An experienced attorney is invaluable, no matter what your recovery efforts include.

Starting the Claim Filing Process

Once you notify your employer of your injury, you can start the claim filing process. If you sought emergency care for your injury, you would need to see a workers’ compensation physician once you stabilize. Alternatively, if it is safe to do so, you can stabilize an injury with first aid and then proceed directly to a workers’ compensation doctor. One of the best things you can do immediately following any injury at work is to secure legal counsel from an experienced and trustworthy attorney.

Filing your claim will be similar to filing a claim for any other type of insurance coverage with the added complexity of your employer as an intermediary between you and their insurance carrier. Your claim form must include the medical report from your workers’ compensation doctor and their disability rating of your condition. This rating determines how much you can receive in benefits and for how long.

If any discrepancies arise with your claim, or if the insurance company denies your claim for any reason, you will need an experienced attorney to help you resolve these issues. Once you have secured the best possible outcome, your legal team can then assist you in determining whether you have grounds for further recovery efforts. For example, if your employer took illegal adverse action against you after your injury, this could form the basis of a retaliation claim, and if a third party caused your injury, you could have grounds for a civil suit in addition to your workers’ compensation claim.

Determination of Workers’ Compensation Benefits

An injured worker can typically expect two forms of compensation from a successful workers’ compensation claim. First, the insurance carrier will pay for any and all medical care they require to heal as fully as possible from their injuries. This includes all necessary immediate treatment followed by ongoing medical care for severe injuries until the victim reaches maximum medical improvement.

When an injured worker is unable to work during their recovery, workers’ compensation insurance can provide ongoing disability benefits until they can resume their work duties. Total disability benefits are usually about two-thirds of the claimant’s average weekly wages, and they may qualify for partial disability if they can still work with reduced earning capacity after their injury.

Hiring an experienced workers’ compensation attorney is the best way to ensure a fair determination of benefits for your workplace injury. If you suffered any type of permanent harm from your experience, you could be entitled to claim much more compensation than you initially anticipated at the outset of your case. Some insurance companies will try to settle these cases with large lump sum offers, and an attorney can advise you as to whether any such offer would suit your best interests.

FAQs About Workers’ Compensation Claims Process in California

How Soon Should I File a Workers’ Compensation Claim After an Injury?

You must report your injury and begin the claim filing process within the one-year statute of limitations for workers’ compensation claims. However, it is always best to report your injury and start the claim filing process immediately after a workplace injury occurs. This will limit the room for the insurance company to doubt the validity of your claim and streamline your receipt of benefits.

What Happens If an Employer Refuses to Provide Claim Forms?

Employers in the state are legally required to facilitate their employees’ workers’ compensation claims. If an employer does not have appropriate insurance coverage, refuses to provide an employee with the materials needed to file their claim, or terminates an injured worker before they can file their claim, they face severe legal penalties. They face full liability for the injured worker’s damages and further penalties at the state and/or federal level.

How Long Does It Take to Receive Workers’ Compensation Benefits in California?

If you have legal counsel you can trust advising you after a workplace injury, you could potentially secure an acceptable determination of benefits within a few days or weeks of filing your claim. If your claim is contested in any way, it could take much longer to resolve. Additionally, if you have grounds for further legal recourse, the full scope of your recovery efforts will likely extend beyond the time required for your workers’ compensation claim.

What Happens If a Third Party Caused My Injury?

California workers’ compensation laws may prevent you from filing a civil suit against your employer in response to a workplace injury, but this does not mean you are without grounds for legal action outside of your workers’ compensation claim. In the event any third party outside your workplace bears fault for a workplace injury, you can file a personal injury claim against them in addition to your claim for workers’ compensation benefits.

The right attorney is an invaluable asset no matter what type of injury you suffered or what you expect in your recovery efforts. The Barry Law Group is ready to provide the comprehensive legal representation you need to maximize your recovery from a serious personal injury. Contact us today and schedule a consultation with an experienced California workers’ compensation attorney you can trust.