Workers’ Compensation FAQs

What is Worker’s Compensation?

Workers Compensation is an insurance program that was established by California State Law which all businesses having one or more representatives, are required to have for the benefit of their employees. Worker’s Compensation law explains the privileges of labors or workers who are harmed/ injured during working or turn out to be sick or crippled in view of work related damage, and permits harmed laborers/ workers to recuperate benefits. Who pays for Worker’s Compensation Insurance?

The employer is required by law to pay for Workers’ Compensation Insurance in order to provide medical benefits to workers. There is no deduction from the salary of an individual employee. How can I minimize the risk of getting injured while working?

In order to minimize the chances of getting hurt, you must get proper worker training to know about the procedures to promptly handle unsafe conditions. What is the first thing I should do if I get injured while at work?

In case you get hurt while you are at work, you should immediately inform your supervisor or employer so that he/she is aware of the incident. Report the ailment and seek medical treatment without any unnecessary delay because if you report promptly, it’ll help you to prevent the problems and receive the benefits instantaneously. When should I file a claim if I get injured on the job?

After the injury has been reported to the employer and you have received proper medical treatment, you should fill out a claim form. The claim form is also called a “DWC 1” and a copy of notification is handed over to the employer. You may receive more information from your employer within 24 to 48 hours of your injury. Can the employer fire me from my job for filing a claim?

No. It’s illegal for your employer to fire you from the job as a form of “punishing you” for filing a workers’ compensation claim if your injury or disability was caused due to work. Also, your employer can’t fire other employees for supporting you in your case. What benefits are provided by Workers’ Compensation Insurance?

Five basic benefits are provided by the Worker’s Compensation insurance. These benefits include:

· Medical Benefits: In case you get injured while at work during your job, your employer pays all the medical expenses to help you recover from injury / illness as soon as possible.

· Death Benefits: If the injury is severe and the worker dies from the compensable injury, the family of the worker (including spouse, children and other dependents) will get an amount equal to two-thirds of the worker’s weekly salary.

· Security Benefits: A worker who turns out to be truly handicapped, either for entire life or for a ceaseless time of at least 12 months, as an aftereffect of a medicinally definite physical or mental hindrance might be qualified for the installment of month to month Social Security advantages.

· Temporary Disability Benefits: The worker will receive payment from the employer if the worker can’t do any job. Worker will receive the payment until he/she is recovered completely.

· Permanent Disability Benefits: The worker will receive a specific amount from the employer if the worker doesn’t recover completely after the injury caused during the work. What kinds of Employees are Covered under Workers’ Compensation Law?

The Workers’ Compensation Law covers all employments including part time employees, full time employees and volunteers working for a for-profit business. Can I choose any doctor for an on-the-job injury?

Yes, if your employer allows you to choose a specific doctor, you can. But if your injury is severe, you may have to be treated by a doctor of the employer’s choice. What kinds of disabilities are covered under Workers’ Compensation Law?

Workers’ Compensation Law covers all disabilities that are accidental due to which the worker is unable to continue working. The injury must be work-related and caused during the job, or at the workplace. What if the worker fails to file a claim for worker’s compensation?

If the employee doesn’t file a claim for Workers’ Compensation due to any reason, the worker may not qualify for any kind of benefits and medical-related care. What is the penalty for employees in the case of a false claim?

If the employee misrepresents the situation in order to get benefits, he/she may be fired from the job by the employer and the employee can be liable for felony-related charges, including breach of Workers’ Compensation law. What can be done if an employee is not satisfied with the decision taken by board after reviewing his/her application?

If an employee is not satisfied with the decision taken by the Board after reviewing the application, he/she may file an appeal to the Appellate Division within 30 days after the decision was made. How can an employee determine a weekly cash benefit for Temporary Total Disability?

The employee can determine the weekly cash benefit for temporary disability (which is approximately equal to two-thirds of his/her weekly wage) for one year immediately after the injury. Will I still get paid if I can’t work due to the severe injury?

If your physician says that you are currently unable to work and are advised to take rest by the physician, you will receive the temporary disability benefits and receive two-thirds of your average weekly wage. What benefits will I receive if I am still able to work while recovering?

In the case you are able to continue working after some time while recovering, you will get temporary partial disability benefits. The amount of temporary disability benefits is about two-thirds of the wage you lose while recovering. Are prescription drugs and medications covered?

Yes. The claimant must send a bill and letter signed by the doctor to the insurance carrier. The letter states that all the purchased medicines were necessary for the treatment and in accordance with the physician’s direction. How long will I continue to receive treatment?

You will continue receiving the medical care until you are completely recovered from the injury and you are able to move around and work. It will continue for as long as it is necessary. What will happen if my doctor’s appeal for management is not accepted?

There are precise time limits you must meet up or you will lose essential rights. Medical treatment disputes for all dates of injury will be resolved by treating doctors through the process of independent medical review. If you have been denied by a doctor for medical treatment because the doctor thinks that the treatment is not necessary for that disease, you can request for a review of that judgment through IMR. Along with the written letter that deprived of or modified your requested treatment, you will obtain an indescribable but completed IMR form and an addressed cover. What will happen if I differ with the MPN doctor’s management plan?

You can disagree with your MPN doctor about your management. You can get treatment from another medical doctor on the MPN list. You have the choice to go for 2nd and 3rd opinions from special MPN doctors. Who will pay for my lawyer?

You do not have to pay your lawyer or anyone who assists with your claim. The Workers” Compensation Commission decides the attorney’s fee. If you are given compensation, then the fee will be deducted from your disability grant. What is accident leave?

Accident leave is financial compensation for time missing from work due to an occupational accident if (a) it is decided by the administration whether this accident and time loss is liable for compensation or not under the Workers’ Compensation Act and (b) a medical doctor physically /completely examines the employee or employees and certifies that the employee is not able to work as a result of the accident in the workplace. The employee would get accident leave after a decision by the Workers’ Compensation Manager. Employees/employees are entitled for accident leave only if they are classified as “regular employment status”. Independent Contractors and most Interns are not eligible for accident leave. How much I will be paid during an accident leave?

Accident leave compensates up to two thirds (2/3) of the employee’s gross salary. It is non-taxable, non-cumulative, and is offered for up to six (6) months from the first day of injury. What type of services/benefits does California Trial Law Group provide to injured employees?

At California Trial Law Group, we help our clients get early and maximum benefits for their work injury claims or personal injury claims. Our legal team makes this process hassle-free for the injured person. Do you provide free consultation to clients?

Yes, At California Trial Law Group, we provide a free consultation to our valuable clients, and we do not charge our clients any upfront fees until we win or settle the case! What should I do if my spouse, child or parent has passed away while collecting Workers’ Compensation Benefits?

If your spouse/child or parent passes away while collecting Workers’ Compensation Benefits, you should notify the Insurance Carrier and the Board immediately. You should also submit a copy of the Death Certificate to your employer as well as the Insurance Carrier. As a widow/widower, will the benefits continue once they passed?

Benefits may stop, in most cases. In order to get a chance to continue, you should file for a Employees’ Compensation Death claim. You should also show proof with medical records to explain that the claimant’s death was due to a work-related injury. Only then can benefits continue.