Filing a worker’s comp claim in California can be a confusing process. It also comes with many deadlines that could prematurely end your claim. If you have never dealt with the worker’s compensation system, you might miss out on benefits to which you were entitled.
Your employer should inform you about your rights and provide some limited assistance in filing your claim. You can also get assistance from a personal injury attorney who can guide you through the claim process.
Here are six steps to filing a worker’s comp claim.
Report Your Injury to Your Employer
You must report your injury to your employer to start the worker’s compensation claim process. If you do not report your injury, your employer has no obligation to try to find employees that may have been injured.
Worker’s comp covers work-related injuries that occur due to a single event or long-term exposure to workplace conditions.
Some examples of workplace accidents that produce injuries that are covered by worker’s comp include:
- Auto accidents
- Construction accidents
- Falling objects
- Machinery accidents
When you suffer in one of these accidents, you should report the accident as soon as possible. If you wait more than 30 days after your accident to report it to your employer, you may jeopardize your right to worker’s comp benefits.
Some workplace injuries occur over time. Some examples of injuries caused by repeated or continuous exposure to unhealthy conditions include:
- Hearing loss
- Toxic exposure
- Repetitive stress injuries
When you suffer from one of these injuries, you should report the injury within 30 days of discovery. Waiting longer than that might risk denial of a worker’s comp claim.
Fill Out the Worker’s Comp Form
Your employer must provide you with the worker’s comp form within one day of hearing about the injury. If you are still coming to work, your employer might deliver the form in person. If you are unable to work, your employer is only required to mail the form within one day of hearing about the accident. The form is also available online if your employer fails to provide a copy to you.
The form asks for identifying information, such as your name, address, and Social Security number. It also asks for information about the injury. Specifically, you must describe:
- The injury date
- Where the injury happened
- Which body part was injured
Even though the form asks for a Social Security number, undocumented workers can receive worker’s comp benefits.
Return the Form to Your Employer
Once you complete the injury form, you need to return it to your employer. The employer must forward the form to their worker’s comp claims administrator. The employer must also provide you with a copy of the form after the employer fills out its section. All of this must happen within one day of receiving the completed form from you.
Get Medical Treatment
Within one day after receiving your completed worker’s comp form, your employer will authorize up to $10,000 in medical treatment for your injury. You are entitled to use this benefit for your injuries, even if your claim is eventually denied.
Getting medical treatment will help your claim in several respects:
Diagnosing Your Injury
When you seek medical treatment, a doctor can diagnose your injury. This may help you as the worker’s comp insurer investigates the claim because it could link your injury to your work.
Developing a Treatment Plan
Worker’s comp pays for all reasonable treatment. By beginning treatment, you and your doctor stake out the treatment you think you reasonably need.
Documenting the Reasons for Missed Work
The doctor can provide you with a note excusing you from work. You may need this evidence if the insurer questions the amount of work you missed.
Cooperate with the Insurer’s Investigation
The worker’s comp insurer has 90 days to review and investigate your claim. During this time, the insurer might request copies of your medical records and other documents relating to your injuries.
The insurer might also schedule a deposition to question you under oath. You should consider hiring a lawyer before attending a deposition to help you understand and respond to the insurer’s questions.
The insurer can ask that you undergo an independent medical examination by a doctor that is selected by the insurance company. Again, you should consider talking to a lawyer before going to the exam so you know what you should or should not do during the exam.
You should cooperate with this investigation so that the insurer can process your claim. But you should also remain aware of any attempts to twist the information you provide so that the insurer can deny your claim.
Pursue a Hearing if Your Claim is Denied
If the insurer denies your claim, you can request a hearing before a worker’s compensation administrative law judge (ALJ). The ALJ has experience in worker’s comp cases and has the power to review claim decisions. Before attending a worker’s comp trial, you should consider hiring an injury attorney to present your case at the hearing.
Getting Help with Worker’s Comp Claims
California designed its worker’s comp claims to be simple. But your employer and its insurer have a financial incentive to deny your claim. Hiring an injury attorney to help with your worker’s comp claim can provide someone to fight for your right to worker’s comp benefits.
Contact the Lalezary Law Firm to schedule a free initial consultation with a friendly and experienced personal injury lawyer. Our firm has successfully helped many workers with their worker’s comp claims. We will bring the same results-driven work ethic to your case. We Fight. You Win. They Pay.