How Workers’ Compensation Works in California
California is a no-fault state when it comes to workers’ compensation. This means that, in theory, neither employers nor employees are held at fault for accidents. Employees can make claims regardless of their roles in incidents and will refrain from filing suits against the employer. The employer, in turn, carries insurance to pay workers’ compensation claims for incidents and conditions that arise.
The system sounds great on paper, but it does not always work as planned. Employers might try to intimidate you out of making your claim, or the insurance company might refuse to pay. In some cases, the employer or insurance company might even try to low-ball you so that you don’t get what you deserve for your case. Only an experienced attorney that represents your best interests can give you an unbiased estimate of what your case is worth.
What Is Workers’ Compensation?
If you develop injuries or illnesses on the job or due to your work, workers’ compensation covers medical bills and lost wages while you recover. Should you pass away, your spouse or dependents might become eligible to receive the workers’ compensation that would have otherwise been due to you.
Some states do not have a mandatory requirement for employers to carry workers’ compensation insurance or only require mid to large companies to do so. The Golden State isn’t one of them. According to the California Department of Industrial Relations, even employers with only one employee must carry workers’ compensation insurance.
Note that, in California, even undocumented immigrants are entitled to workers’ compensation benefits. These are some of the benefits the state requires in workers’ comp plans:
- Medical care
- Supplemental job displacement benefits
- Return-to-work supplements
- Temporary disability benefits
- Permanent disability benefits
- Death benefits
What Are Some Qualifying Injuries and Illnesses?
An unfortunate fact is that many Americans who are eligible for workers’ comp never claim it because they do not know they have a qualifying illness or injury. While most people know that accidents are covered, they might not know of the additional conditions they can file a claim for.
Did you know that you can receive benefits for mental health problems in California? California is one of several states that have strong provisions in place for claims based on psychiatric injuries. Common examples of mental health problems you might make claims for include burnout from working too hard or PTSD from witnessing a violent incident at work.
Repetitive Motion Injuries
In today’s world of high levels of specialization, repetitive motion injuries are incredibly common. From the architect clicking on a mouse all day to the court reporter using stenographs and packers at retail warehouses, many workers complete repetitive tasks. These can stress the body, leading to tendonitis, carpal tunnel syndrome and other illnesses.
Some occupations also have a high likelihood of exposing workers to harmful chemicals and biohazards. Common examples might include a nurse who contracts HIV after coming into contact with a patient’s body fluids or a construction worker who develops lung cancer from asbestos exposure. In fact, even office workers can develop asbestos if they work in an old building that was not properly repaired or renovated.
As mentioned before, accidents are the cases that workers are most familiar with. These can range from slip-and-falls to falling from great heights to dismemberment. It is important to note that an injury resulting from an accident you caused still qualifies for workers’ comp in California, even if your employer tries to tell you otherwise.
What Is the Process for Filing a Claim?
Only an experienced attorney can provide details on how to file a claim. This is because every case is different, and the way you handle it depends heavily on what obstacles your employer or its insurance company puts in your way. Here are some general steps most people follow.
1. See a Doctor
You may or may not have the right to choose who your health care provider is. Find out what your options are and then seek medical attention. Only a physician can determine whether you were injured, how bad it is, whether you should return to work and when you can do so.
2. Report the Incident
You must notify your employer that the incident took place. If you are conscious but severely injured, ask a trusted colleague to report the incident on your behalf. For more minor situations, report the incident immediately. If you rely on someone else to do it, always follow up.
3. Collect Evidence
In the best-case scenario, your employer’s estimate lines up with what you have in mind. However, your case might still be worth much more than you know. An experienced attorney can provide an estimate based on the evidence you provide. If you need to appeal a denial or go to court, the evidence is also useful there.
4. Submit Claim Form
Your employer should send you a claim form within one business day of the incident occurring. If it fails to do so, you can download one from the DWC. An attorney can assist you with filling the form out correctly and following the proper procedure for submitting it, such as using certified mail instead of regular mail.
Do I Need To Work With an Experienced Attorney?
You have probably heard stories of people who pursued their own workers’ compensation case and won. These cases do exist. However, insurance companies have experienced financial experts and attorneys that fight to help them minimize payouts and boost profits. The insurance company also tends to lend its resources to the employer it covers.
When an insurance company or employer prepares to fight, you need an experienced attorney to review your case and provide you with crucial advice. An attorney can also represent you in the courtroom. His or her expertise might also become indispensable if your employer later tries to retaliate against you.
Finding a good workers’ compensation attorney is not always easy, especially when cases end up going to trial. We can match you with an experienced local lawyer. Submit a request online or call us today at 866-345-6784 to get in touch with an attorney in your area!