How to Report a Workers’ Comp Claim in California

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When a work-related injury occurs, employees can file for benefits through the California Division of Workers’ Compensation. The program covers all accident-related medical expenses, a portion of wages lost from missed days at work, and disability benefits if applicable. To receive compensation through this program, employees do not have to prove negligence. However, there is a specific process for filing and receiving workers’ comp benefits for a workplace injury or illness. Deviating from this process can result in less compensation than your injuries are worth – or a denied claim. Here’s how to go about filing.

Report the Accident to Your Employer

The first step is telling your employer about what happened. Describe the accident, name any eyewitnesses, and report any injuries. If you hit your head but are unsure of whether you sustained an injury, seek medical attention. You may have a concussion that isn’t showing immediate symptoms. Your employer must legally allow you to leave work and see a doctor after a work injury.

If the visit results in a diagnosis of accident-related injuries, give this information and medical documentation to your employer. Failing to report to your manager or human resources department can lead to suspicions about your claim down the road. File a report as soon as possible – directly after a traumatic incident or as soon as you discover an illness you believe came from your job.

File a Claim with the Workers’ Compensation Insurance Company

After you speak with your employer, he or she should file claim with the company’s workers’ compensation insurer on your behalf. Your employer will ask you to fill out the DWC 1 form, which includes a description of your injuries. Return the completed form to your employer, who will then fill out his/her portion. It is then the employer’s duty to file the form with the workers’ compensation insurance carrier within 24 hours. Ask for a copy of the form for your own records. If, for some reason, your employer does not achieve successful accident reporting, take your claim into your own hands. You can hire a San Diego injury lawyer to pursue your case directly with your employer’s insurance company.

Receive Medical Care for Injuries

Once the employer files a claim, the insurance carrier must authorize an amount not exceeding $10,000 in medical care for the injured employee while the company either denies or accepts the claim. California laws give insurers 90 days to complete this process. The insurance company has the right to select the healthcare provider in the first 30 days following the filing of the claim form. However, the injured party can select his or her own doctor after the first 30 days. Ask your employer if there is a specific doctor you must see for your injuries. If there isn’t, go to your primary care doctor and explain what happened.

Timely medical attention and adherence to your treatment plan is important for the success of your case. Waiting to see a doctor can signify that your injuries aren’t serious or that you’re making them up. Seek medical attention as soon as possible after a workplace accident or after you suspect you contracted an illness from work. Keep copies of all medical records and documents, including your bills. If you have to take time off of work during recovery, document your lost wages as well.

Visit an Attorney

The California workers’ compensation program will give benefits to injured employees regardless of the circumstances of the accident – unless the employee caused his/her injuries through horseplay or criminal acts. If you’re having trouble getting workers’ comp benefits for your work-related injuries, contact Liljegren Law Group for help. A licensed professional can investigate your claim, see what went wrong, and help you pursue the recovery you deserve.