Most of us spend a significant part of each day at work. Although some occupations are obviously more dangerous than others, employees can be injured in any work environment. The California workers' compensation system has been designed to provide benefits to workers injured on the job, including medical care and disability benefits.
So if you get hurt on the job, what do you need to do?
1. Report Your Injury or Illness
Notify your supervisor or someone else in management as soon as possible after your injury occurs. If your illness or injury is the kind that develops gradually (like carpal tunnel syndrome or a loss of hearing), you should let your company know about it as soon as you believe it is being caused by your job.
Promptly reporting your injury not only means that you'll receive treatment and benefits sooner, but delayed reporting can cause you to lose your rights to compensation. Under California law, a reporting delay of even 30 days can cause a workers' comp claim to be denied.
2. Get Emergency Medical Care
If your injury arises suddenly and must be treated immediately, call 911 or go to an emergency room. Tell the medical staff that your injury is work-related.
3. Fill Out and File a DWC-1 Form
Your employer must give you a DWC-1 Form to claim workers' compensation benefits within one working day after you report your injury. Read all of the form's instructions and fill out the "Employee" part of the form.
Be sure to completely describe your injury or illness and every part of your body that you believe has been affected by it.
You should deliver the completed form to your company in person or mail the form by First Class or Certified Mail (mailing it certified is more expensive but will provide you with proof that your employer received the form).
Your claim for workers' compensation benefits is considered officially "filed" once you have returned the DWC-1 to your employer.
Your company must then complete the "Employer" portion of the DWC-1, deliver it to your company's claims administrator (in most cases this is an insurance company) and provide you a copy of the completed form.
Keep this copy of the DWC-1 for your records.
The claims administrator is required to accept or deny your claim within a reasonable period of time (typically within 90 days).
4. Get Medical Care for Your Injury
The workers' comp system requires you to be treated by doctors paid for by your employer. If your company doesn't have a Medical Provider Network (MPN) or Health Care Organization (HCO) for injured workers, the claims administrator will refer you to a doctor for treatment.
If you predesignated your own doctor or medical group before your injury, you can seek treatment from your own doctors.
The doctor who treats you is known as the primary treating physician, and his or her duties under California law are to:
Determine the appropriate treatments for your injury;
Manage your overall care if multiple doctors are involved;
Decide when you can return to work and the kinds of work you can do while recovering; and
Refer you to specialists when needed.
You should tell the primary treating physician about how your injury happened, all of your symptoms and your job duties/work environment.
5. Keep Good Records
Save every document related your workers' comp claim, injury and treatment:
The DWC-1 Form and any related correspondence with your employer and the claims administrator;
Medical reports, doctor bills, and health insurance claims;
Pay stubs from before, during and after your medical treatment; and
Out-of-pocket expenses related to your injury, like prescription drug copays and travel expenses related to doctor visits.
6. Hire a Lawyer
If your workers' comp claim is denied or your company and claims administrator aren't responding to your claim, you should consult an experienced workers' compensation lawyer to find out what rights you have under California law.
Even if your workers' comp claim has been accepted, disputes often arise over medical treatment, the payment of benefits, changes to your work duties while you are recovering and when you are expected to return to work.
A workers' comp lawyer can help you resolve these disputes, prepare the required documents and meet the filing deadlines in your case.
The lawyers in the Law Office of Roy C. Levin have more than 20 years of experience representing injured workers. Contact us at (916) 447-6636.