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  • DIRECTORY

Workers Compensation Law

California worker compensation laws are numerous, and the role of the workers’ compensation lawyer in defending employee and employer rights gains importance as California approves more laws regarding workers’ compensation.

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Glossary of Legal Terms

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Key Terms and Issues in Workers’ Compensation Law

  • Types of Injuries Involved in Workers’ Compensation Cases
  • Examples of injuries may include:

    • Specific injury events: breaking a bone in a fall, getting burned by a chemical explosion or getting injured in a car accident while driving for an employer
    • Ongoing repetitive injuries: carpal tunnel or a frozen shoulder from doing the same motion over and over, or losing your hearing because of loud noises in a factory
    • Some stress-related injuries
    • It is important to note that a work-related injury does not have to be as a result of employer’s negligence or some other party’s fault. Workers’ compensation is a no fault system. Even if it is your own fault in causing your own injury, workers’ compensation benefits will be provided.
  • Filing a Claim Form (DWC-1): The Very First Step
  • The DWC-1 is the form that your employer should give you when you report that you have been injured. Read all of the information on the form and keep this and all other papers for your permanent records. To file a DWC-1 claim, complete the section titled “Employee” on the form, and then keep one copy and give the other copies to your employer. Your employer will complete the section titled “Employer” and then will keep one copy, give you a dated copy and send a copy to the claims administrator. Complete the form as soon as possible to preserve your right to receive benefits as needed. Your right to benefits depends on the nature and facts of your claim. Additionally, the claims administrator responsible for handling your claim may contact you.

    While you do not need a workers’ compensation lawyer to file the DWC-1 form, you may need or may want to hire an attorney if you find that your employer does not carry workers’ compensation insurance, or if there are other complications in your case.

    It is a criminal offense for an employer not to carry workers’ compensation insurance, and it is also a criminal offense for an employee to file a DWC-1 report that an injury was caused on the job when it was not; fraud in California is a crime, punishable by imprisonment.

    After Filing a DWC-1
    Within one working day after you file a DWC-1 claim form, your employer must approve medical treatment for the reported injury, and they shall continue to be liable for up to $10,000 in treatment until the claim is accepted or rejected by the employer’s insurance company.

    You may be entitled to the following benefits:

    • Medical care
    • Temporary disability benefits, which pay you a portion of your salary if you miss work as a result of your injury
    • Permanent disability benefits if you have some long-term ratable impairment from your injury
    • Supplemental job displacement vocational training voucher
    • Death benefit
  • How to Report an Injury
  • California’s Worker Compensation Laws about Injury Reporting
    Tell your employer or supervisor right away if you have been injured on the job, unless it is just a minor cut or something requiring only first aid treatment. When in doubt, report the injury. In a repetitive job injury, such as carpal tunnel, tell your employer as soon as you realize that you need to seek medical help for the problem. For an acute injury, get emergency treatment.

    In most cases your employer’s insurance company will have a medical treatment network and you will be required to treat within that network. If you have previously filed a predesignation form with your employer you may treat with your personal physician for any injuries occurring on the job. In most circumstances, late reporting of an injury could jeopardize your claim.

  • Temporary/Permanent Workers’ Compensation Disability Payments
  • Temporary Disability Payments
    Temporary workers’ compensation disability payments are tax-free payments that equal two-thirds of your average weekly pay, within minimums and maximums set by state workers’ compensation laws and for specific amounts of time depending on the injury. These payments may change or stop when your doctor says you are able to return to work either on a full-time or part-time basis. Your employer may provide you with some type of modified work in lieu of paying disability payments.

    Permanent Disability Payments
    When your treating doctor determines that your injury or illness results in a permanent disability from which you will not completely recover, you may receive additional workers’ compensation disability payments according to state laws. A settlement of your case may be paid in a lump sum which is known as a Compromise of Release (C&R), but medical care will be closed; other settlements are paid weekly in a Findings and Award (F&A) and medical care will stay open. A workers’ compensation attorney may be consulted to better navigate these settlements.

    The amount you get paid will depend on the type of injury, your age, occupation and the date of injury, and will be impacted by how the injury affects your ability to work and your ability to do your normal life activities. Worker compensation laws determine if your permanent benefits may be paid in a lump sum and if it includes future medical payments for any necessary medical treatments for your injury. This is called a stipulation with request for reward (Stip). You may also settle your case through a compromise and release (C&R), which means you will get a better settlement but you will be responsible for your own medical care for your injury or illness.

  • Medical Care
  • Medical care is paid for by your employer to help you recover from an injury or illness caused by work. There are no deductibles that need to be met, nor are there any co-pays required with workers’ compensation laws. Your claims administrator will pay all reasonable and necessary medical care for your work injury or illness as long as the medical treatment is deemed necessary by a review process.

    Medical benefits may include treatment by a doctor, chiropractor, acupuncture, x-rays, blood tests, hospital services, physical therapy, lab tests and medicines. Your claims administrator will pay the bills directly to the provider. You will also be entitled to mileage costs traveling back and forth to your appointments.

  • Supplemental Benefits
  • Do California’s worker compensation laws provide for additional workers’ comp benefits?
    The general goal of workers’ compensation laws in California is to return injured workers to work as soon as possible, so it is important that you communicate not only with your doctor and claims representative but also with your employer to see if they have a job you can do while you are recovering from your injuries. Sometimes this will be some sort of modified work, i.e., a police officer injured in the field may only be able to do desk work for six months after returning to work. If the employer does not have work available, then you may be entitled to workers’ compensation benefits determined by state laws and the claims administrator.

    Within 60 days after your temporary disability ends (if your date of injury is in 2004 or later), and if your employer does not offer modified or alternative work, you may qualify for a compensation benefits voucher that is payable to a school for retraining so you can get a different job. This voucher is called a Supplemental Job Displacement Benefit (SJDB) and is valued at $6,000. It cannot be cashed-in and can only be used for training. The voucher can be used in part to obtain assistance from a vocational counselor.

  • Death Benefits
  • If a work-related injury or illness causes the death of an employee, workers’ compensation laws dictate that payment of workers’ compensation benefits may be made to family members who were financially dependent on the deceased worker.

  • Return to Work
  • Worker Compensation Laws in San Diego & When to Consult Workers’ Compensation Attorneys
    You may or may not need time off work after an injury, and that will be decided by your treating doctor. He/she will additionally determine the appropriate time for you to return to work, if you are off work during your recovery, while consulting workers’ compensation laws that apply in the state of California.

    To help you to return to work as soon as possible, you should openly communicate with your treating doctor, claims administrator and employer about the kind of work you can do while recovering. They may coordinate efforts to return you to modified duty or other work that is medically appropriate. Sometimes a study of your workplace environment will be ordered to see if it is ergonomically appropriate, for example, in a repetitive injury case to decrease the possibility of further injury.

Do You Need a Workers’ Compensation Lawyer?

  • When to Contact a Worker Compensation Lawyer
  • If you have been injured on the job but are unsure of workers’ compensation laws or the next steps because of your specific situation, then you should speak to an attorney. You can obtain assistance from an attorney from the day the claim is filed to the end of the case. You can get a referral to a workers’ compensation attorney by calling the SDCBA’s Lawyer Referral and Information Service at 619-231-8585. You will be entitled to a free 30-minute consultation.

    Attorneys that represent injured workers in workers’ compensation cases do not charge any upfront fees and do not charge hourly rates; fees are paid as a percentage of a final settlement or award. If you are considering obtaining an attorney, consult one that specializes in workers’ compensation law, and not a general practitioner.

  • Assistance Filing a DWC-1
  • While you do not need a worker compensation lawyer to file the DWC-1 form, you may need to hire an attorney if you find that your employer does not carry workers’ compensation insurance.

    It is a criminal offense for an employer not to carry workers’ compensation insurance, and it is also a criminal offense for an employee to file a DWC-1 report that an injury was caused on the job when it was not.

What to Ask Your Lawyer?

  • What do I do if I am not receiving my workers’ compensation payments?

Disclaimer: The information on this page is to aid your general understanding of general law issues and terms. This information does not constitute legal advice and should not be depended upon for that purpose. Laws are constantly changing and may at any time render the information found here invalid, so you will want to do further research on your own. For legal advice, consult an attorney. If you need a referral to an attorney, contact the SDCBA’s Lawyer Referral and Information Service at www.sdcba.org/ineedalawyer.

Community and Other Resources

  • State Division of Workers' Compensation (DWC)
  • Worker’s Compensation, State of California Department of Industrial Relations
  • San Diego Law Library
  • Issues with your attorney's bill?
  • Workers’ Compensation: Types Of Injuries And Filing A Claim (The Very First Step), SDCBA Blawg401

 

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