Filing a Worker’s Comp Claim in California: Understanding Your Rights

California companies must have worker’s compensation covering all worker-related injuries. Worker’s compensation covers medical treatment costs, provides financial benefits to injured workers, and death benefits to families. Unfortunately, unethical companies fail to comply with these laws and may deny benefits to qualifying workers. Read on to learn how to file a worker’s compensation claim.

Report the Accident

The worker must report the accident to their employer for worker’s compensation benefits within one month of their injuries. The employer must provide a worker’s compensation claim form within 24 hours after the worker reports the accident. If the employer doesn’t provide a form, the worker can download and print a form from the State of California Department of Industrial Relations website.

Seek Medical Attention

Employers must send the worker to a medical facility for assessment and treatment after providing a worker’s compensation claim form. Many employers have a specific medical center where they send employees after these accidents. However, the worker can visit any doctor they prefer to get a second opinion at their own expense.

The doctor must complete the worker’s compensation claim and send it to the employer’s insurer. They must provide medical files explaining the worker’s injuries and details, such as treatments or surgeries. The doctor must also specify how long the worker will be absent from work due to their injury. If the worker sustains a disability, the doctor must explain how it is a disability, how the injury affects the worker’s life, and if it’s a permanent or temporary disability.

Under employment laws, the employer’s insurer can require a drug screening. The insurer can deny the claim if the worker fails the drug test. Workers who take prescription medications daily must disclose these medications to the medical facility.

The medical staff can assess the drug test according to the worker’s prescribed medication details. Workers cannot be denied benefits based on medications prescribed to them by a doctor if they follow their doctor’s instructions. Insurers can deny worker’s compensation benefits if the drug test results indicate prescription drug abuse.

Comply With HR Requirements

Comply with instructions provided by your company’s Human Resources department. For example, some companies may require a doctor’s excuse for a predetermined number of employee absences. Secure a doctor’s excuse if required by your employer, even if you have filed a worker’s compensation claim. Work absences could count against you if the insurer denies your worker’s compensation claim.

Consult an Attorney

Worker’s compensation benefits are available to workers who are injured on the job. Types of injuries that may be covered include accidents such as slip and falls, burns, broken bones and sprains, as well as injuries incurred over time, such as illnesses due to exposure to hazards chemicals and repetitive stress injuries. You must sustain the injury while completing job duties. Workers must report these injuries within 30 days from the day of the accident. The injuries cannot be self-inflicted or result from a crime committed by the victim, and the victim must be an employee of the company. Independent contractors or gig workers aren’t eligible for worker’s compensation benefits.

Qualifying workers denied worker’s compensation benefits can seek compensation through a civil lawsuit. An attorney can help them secure evidence, such as surveillance footage, medical records, and eyewitness accounts.

Worker’s compensation claims start with your employer. However, some companies use loopholes to deny worker’s compensation claims. A personal injury claim could help you get compensation if you were denied worker’s compensation benefits. Contact an attorney to start a legal claim today.

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