California workers' compensation law is a system focused on employment-related injuries and illnesses that arise from the employment relationship regardless of fault. Workers' compensation is based on a no-fault system, which means that injured workers or ill employees do not need to prove that the injury or illness was someone else’s fault in order to receive workers' compensation benefits.
There is ample opportunity to be injured, so employers must have workers' compensation insurance. This helps cover your injury costs, but can also limits an employee from only bringing these claims in the workers' compensation system.
Whether it's an injured neck from a fall or a hurt shoulder from repetitive motion, if you've suffered a work-related injury in California, you'll need to know the benefits and requirements for filing a workers' compensation claim.
All California employers must provide workers compensation benefits to their employees under California Labor Code Section 3700. If a business employs one or more employees, the business must also provide workers compensation benefits and coverage for each of those employees.
In California, workers' compensation benefits cover all workers, including part-time employees.
Failure to have workers' compensation insurance in California is a criminal offense.
Employers that fail to purchase workers compensation insurance are in violation of the California Labor Code. The Division of Labor Standards Enforcement could issue a stop order against any employer that is uninsured for workers comp. A stop order closes down business operations until workers compensation insurance can be purchased. The Division of Labor Standards Enforcement can also assess fines.
Failing to have workers compensation coverage is a criminal offense. Either or both of these punishments may apply:
If an employee gets injured or sick because of work and the employer is not insured, the general rule is the employer is responsible for paying all the bills related to the illness or injury. The employee may also file a civil action against the employer in addition to filing a workers compensation claim.
There are five types of benefits that injured or ill workers may be entitled to. Depending on the circumstances, workers may be eligible for more than one type of temporary disability payments.
Those injured on the job are entitled to the medical treatment required to cure or alleviate their work-related injury or illness. This includes hospital bills, physical therapy, physician visits, prescriptions, X-rays, lab tests, and any other medical care considered necessary by the treating physician to address the injury or illness.
If a workplace injury limits a person from returning to work within three days of the incident, they are entitled to temporary disability benefits. Temporary disability helps to replace two-thirds of wages or lost wages as a result of being unable to work due to the injury. This replacement wage is generally paid bi-weekly either until the employee can work again or their condition becomes permanent.
Permanent disability payments results when an injury or illness sustained on the job leads to a permanent impairment that prohibits them from doing their job. The amount permanent disability benefits received depends on multiple factors such as age and extent of the injury and can be paid in a lump sum or weekly payment until the maximum amount set by state law is reached.
If a workplace injury or illness results in you not being able to return to the same type of job, the supplemental job displacement benefit could be useful. It is a voucher the injured employee can use to go towards up to $6,000 of fees associated with education-related training or skill enhancement. This supplemental job displacement benefit can help a person get a different job that is possible to complete with their injury.
If an employee is fatally injured in the workplace, reasonable burial expenses are paid under workers’ compensation law death benefits. Depending on the situation, qualified surviving dependents may also be entitled to receive support payments. The amount of death benefits that dependents may receive depends on the number of dependents the employee had and whether they were total or partial dependents.
In California, all employers must meet workplace posting obligations. Workplace postings are usually available at no cost from the requiring agency. The California Department of Industrial Relations requires employers to post information related to wages, hours and working conditions in an area frequented by employees where it may be easily read during the workday.
Additional posting requirements apply to some workplaces. For a list of available safety and health postings, visit the Cal/OSHA publications page.
The table below shows key aspects of California's workers' compensation laws, including the types of benefits and important deadlines.
If you've been injured, you should first seek emergency medical attention (if necessary), or go to either an approved medical provider or your predesignated physician and tell them that your injury or illness is job-related. Additionally, you should provide written notice to your employer of your injury or illness.
Your employer then has one day to give or send you a claim form, but you can also find the workers' compensation form online. You generally have one year to submit your claim form back to the employer, and you should do so in person or by certified mail.
Workplace injuries should always be reported as soon as possible, but California law requires they be reported no later than 30 days after the incident. The workers’ compensation claim needs to be filed within one year of the date of the incident, but as soon as possible after the injury is best.
In keeping with the strict timelines, the employer or claim administrator must authorize appropriate medical treatment within one day of receiving the claim form. If the claim is not denied within 90 days, the injury is presumed to be covered.
If your claim is denied, you have the right to have your case heard by a judge. You must file an Application for Adjudication of Claim with required documents, give notice to the other parties, and file a Declaration of Readiness to Proceed. Your case will be scheduled for a mandatory settlement conference and if the case is not settled there, you will have to prepare documents describing the dispute, identifying what you will present at trial, and give the names of witnesses who will testify.
An attorney can help you prepare the appropriate documents, file on time, and represent you in front of the administrative law judge. If you disagree with the judge's decision after this trial, you may file a Petition for Reconsideration.
Workers' compensation claims are fraught with tight deadlines and strict requirements but are crucial to the recovery process after a work-related injury. Learn more about these requirements and the strength of your claim by speaking with an attorney who specializes in California workers' compensation laws.
Need expert guidance navigating California Workers Compensation Law? Contact Freeburg & Granieri, APC. Our specialized attorneys can provide personalized assistance, ensuring you understand your rights and maximize your claim's strength.
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