In the state of California, workers’ compensation benefits are intended to cover injuries that employees suffer while on the job. If you have been injured in an occupational accident, then your expenses could be covered by workers’ comp.
At Wyman & Hegwer, we are often asked how workers’ comp works in California. We help clients each day with their benefits claims, and we know how confusing the process can be at times.
How Can I File A California Workers’ Compensation Claim?
As soon as you have been injured or are aware of your work-related injury, you should let your employer know. Most employers have procedures in place for reporting these injuries. This is true of any industry in the state of California. Speak with your supervisor or refer to your employee manual.
If the treatment is not a medical emergency, your employer will often be able to refer you to a physician or specialist that is a part of their medical provider network. Employees in this state are required to report their injury within 30 days of the incident.
If you fail to report the accident or injury within this time period, then you could be forfeiting your rights to financial benefits. Once you have received medical care, you will need to fill out the appropriate form and turn it into your employer. The employer will give this form to their workers’ comp insurance company.
There are several additional forms that you will need to file after this in order to make the workers’ compensation claim official. You can ask your employer for these forms. However, the process can get complicated, and you need to be sure to fill out the appropriate forms within the deadline.
In some instances, claims for workers’ benefits are denied. This is why it helps to have an experienced workers’ comp benefits attorney in San Rafael on your side.
Your lawyer will ensure that the proper procedures are followed, and all deadlines are met. The attorney will also negotiate with the insurance company on your behalf to ensure you get the maximum settlement for your injuries.
It is possible to file the workers’ comp claim alone, but if you find yourself unsure at any step of the way, it is in your best interest to enlist the help of a skilled legal professional that has experience with workers’ comp claims in the Bay Area and can help you navigate the process successfully.
Do Employers Have To Provide Workers’ Comp Benefits In California?
The short answer is yes. Employers are required by California law to pay for workers’ compensation benefits for their workers.
Many people incorrectly assume that they can only get benefits if there is a single event that caused the injury. For example, a slip and fall, a car wreck, a machinery accident, or being burned by a chemical that splashes on the skin.
Eligible employees are not restricted to these single events in order to claim workers’ comp benefits. Repeated exposures at work are also eligible for workers’ compensation.
For example, repetitive motions that are performed each day and cause injuries in the back, hand, or other body parts. Carpal tunnel injuries in office workers or back injuries in manufacturing employees are great examples of this.
Workers’ comp benefits may also cover some of the stress-related, or psychological injuries, that are a result of the job. Each case is different, and injuries are not always covered in CA. However, employers must pay for workers’ compensation benefits while they are in business to comply with California state law.
What Happens If My Employer Doesn’t Carry California Workers’ Comp Insurance?
In situations where an employer fails to pay for workers’ comp insurance, the state has California’s Uninsured Employer’s Benefit Trust Fund in place to provide benefits to injured employees. The UEBTF is intended to step in where business owners and employers illegally fail to provide adequate coverage for their injured workers.
Can A Workers’ Comp Claim In California Be Denied?
There are some situations where workers’ compensation can be denied for California employees. You must be considered an eligible employee in this state and the injury must fit certain criteria. Here are some of the instances that an insurance company might deny the benefits claim:
- The injury did not occur at work or was work-related
- The injury occurred as the result of another place of employment
- The injury does not require medical care or treatment
- The injury does not require time off of work
If you are unsure of whether your injury fits any of the criteria above, then it is in your best interest to speak with a Marin County workers’ comp benefits attorney about your claim.
Is There Anything I Can Do If My California Workers’ Comp Benefits Are Denied?
It is not uncommon for employers and insurers to wrongfully deny workers’ comp benefits to employees. If you believe that your claim was wrongfully denied, then you do have legal rights to appeal the decision.
It is possible to file a Declaration of Readiness to Proceed with the Workers’ Compensation Appeals Board in these instances to fight the denial of your benefits. You will need to serve this form to your employer’s insurance company.
A hearing will be held through the Appeals Board to determine the outcome of your claim. This process can be complicated. It helps to have a skilled San Rafael workers’ comp attorney by your side to help you through the appeals process.
Hire An Award-Winning Workers’ Compensation Law Firm For Your Benefits Claim
If you have been injured at work, then you could be entitled to financial compensation for your expenses. You need to act fast for the best chance at a favorable settlement. Consult with a top-rated workers’ comp attorney to discuss your legal options.
Call us now at (415) 448-5107 to schedule your free consultation. We offer affordable, honest legal advice and we’re ready to fight for your rights in your workers’ comp claim.