How to File a Workers’ Comp Claim
If you have been injured while at work in California, you may be entitled to workers’ compensation benefits. Workers’ compensation benefits provide you with the medical treatment so you can recover from your injury or illness, and replace your lost wages while you are unable to work.
However, receiving these benefits can be challenging. Your employer may not give you a claim form or outright deny your workplace injury. If you need assistance with the California workers’ compensation process, contact our workers’ compensation lawyer in Rancho Cucamonga. We offer a free consultation and no upfront legal fees.
1. Report the Injury or Illness to Your Employer
The first step to file a workers’ comp claim in California is to report the injury or illness to your employer within 30 days. You should notify your employer verbally and in writing, and describe how, when, and where the injury or illness occurred. You should also inform your employer of any symptoms or medical treatment you have received, such as emergency treatment.
Your injury may be caused by a one-time accident, like a broken bone from a slip and fall construction accident. It could also be an occupational disease or repetitive stress injury that accumulates over a period of time. As long as the injury occurred while on the job, you likely have a workers’ compensation case.
2. File a Workers’ Comp Claim Form with Your Employer
The second step is to file a workers’ compensation claim form (DWC 1) with your employer. Your employer must give you a form within one business day after learning about your injury or illness. If your employer does not give you the form, you can find it on the California Workers’ Compensation (DWC) website.
Fill out the “employee” section of the claim form and sign and date it. Include your personal information, your employer’s information, and the details of your injury or illness. You should also indicate whether you need to obtain medical care or have lost wages because of your condition.
Return the workers’ compensation claim to your employer in person or by mail as soon as possible. Your employer will then fill out their portion, submit the completed form to the insurance company or claims administrator, and give you a copy. Keep in mind that you have one year from the date of your injury to file a workers’ compensation claim in California.
3. Seek Medical Treatment
Seeking medical care immediately after an injury is one of the most important steps you can take. If you predesignated a doctor in writing with your employer before your injury, then that doctor can be your primary treating physician for your work-related injury.
If you did not preselect a doctor, you will need to choose one through your employers’ medical provider network (MPN) or health care organization (HCO). Your employer may also choose for you.
Until the insurance company makes a decision, you are authorized to receive up to $10,000 in medical treatment while your claim is reviewed.
5. Wait for the Insurance Company’s Decision
Once your claim has been submitted, you will need to wait for the claims administrator to make a decision within 90 days from the date you submitted your claim form. They will either accept or reject your claim. If your claim is accepted, you will begin receiving your benefits, which include medical care, temporary disability benefits, permanent disability benefits, or supplemental job displacement benefits.
If your claim was denied or you want to dispute your benefits, you can challenge the decision.
4. File an Application for Adjudication of Claim
If your employer denies your claim, you can file an Application for Adjudication of Claim with the Workers’ Compensation Appeals Board (WCAB). The WCAB is the judicial branch of the workers’ comp system that resolves disputes between workers and employers or the insurance company.
You can download the application for adjudication of claim from the forms page of the DWC website. However, appealing a workers’ comp decision can be time-consuming and complicated. Hiring a worker’s comp lawyer will be your best bet in winning the outcome you desire.
6. Talk to a Workers’ Compensation Lawyer
Workers’ compensation lawyers are trained legal professionals who understand state labor code and the best medical professionals. If you choose to file a workers’ comp claim on your own, you may not realize the full benefits that you are entitled to.
Additionally, hiring a workers’ compensation attorney can help you stay ahead of deadlines. There are strict deadlines that injured workers must follow in order to claim benefits. If a deadline passes, you will not be able to file a claim or receive benefits.
Lastly, workers’ compensation lawyers do not charge upfront legal fees. Instead they are paid out a portion of your worker’s compensation benefits.
Need Help With a Workers’ Compensation Claim?
The workers’ compensation process can be challenging and complicated, but it can also provide you with valuable benefits for your medical bills, lost income, and more. If you need assistance in filing a claim, contact Sierra Accident Lawyers. Our experienced California workers’ compensation attorney can increase your chances of getting the compensation you deserve for your work-related injury or illness.
If you have any questions or need any assistance with your workers’ comp claim, please contact our law firm today. We are here to help you with your work-related injury needs.