Follow these steps to obtain workers’ comp benefits.
In California, most employers are required to provide workers’ compensation insurance for their employees. Under the California Workers’ Compensation Act, employees who suffer an injury or develop an illness in the course and scope of their employment are entitled to certain benefits through the workers’ comp system. However, to receive these benefits, workers must file a claim.
The first step that you should take after a workplace injury is to seek medical treatment.If you suffered an accident at work, you should get immediate medical treatment. For non-emergencies, you may be required to go to a doctor within your employer’s medical provider network. Either way, make sure that you tell the treating physician that your injury or illness is work-related.
As soon as possible, you should report your injury or illness to your employer. As a California workers’ comp attorney can explain, if you fail to do so within 30 days of your injury or diagnosis of your illness, you could lose your right to benefits. While there are some exceptions to this rule, the best course of action is to make sure that you tell your employer about your job-related injury or illness as soon as you can.
Within 1 working day of reporting your injury or illness to your employer, they should provide you with Form DWC-1, which is a workers’ compensation claim form. Along with Form DWC-1, your employer should give you information about your rights under California law and your eligibility for benefits. Fill out the employee portion of the form, making sure to list every part of your body that was injured. Then give the form back to your employer, who must then fill out the employer part of the form and submit it to the insurance company. Make sure that your employer provides you with a copy of the completed form.
Once this form has been submitted, the workers’ compensation insurance company is required to authorize payment for medical treatment while it investigates the validity of your claim. If the claim is not denied within 90 days of submitted the form, it will be considered approved. In addition, if you cannot work due to your injury or illness, then insurer should begin temporary disability payments within 14 days after you submit the form.
In some cases, this ends the process — the insurance company approves benefits, and you receive the compensation that you need to get better and return to work. But if the insurance company disputes some aspect of your treatment or decides that you do not need disability benefits, you may need to file an Application for Adjudication of Claim. This document opens a case with the Workers’ Compensation Appeals Board. In most cases, employees work with a California workers’ comp attorney to file this form and to move forward with a claim. You must file this form within 1 year after the date of injury, the last day that your employer provided medical benefits, or the date that any temporary benefits ended.
Workers’ compensation cases can be complex, requiring you to file specific forms and meet a number of deadlines. At PLBSH, we are skilled at navigating the California workers’ compensation system. To learn more about how we can help you or to schedule a consultation, contact our law firm today at (800) 435-7542 or email@example.com.