How Does Workers’ Compensation Work in California?

Workers’ compensation benefits provide injured workers with the medical treatment they need to recover from a work-related injury or illness. In addition, workers’ compensation benefits partially replace the wages you lose while you are recovering and help you return to work. Workers’ compensation benefits do not include damages for pain and suffering or punitive damages.

If you’ve been injured on the job, it’s important to immediately notify your employer. In some cases, injuries may develop slowly, such as repetitive strain injuries. Known as RSIs, repetitive strain injuries cause damage to your muscles, nerves, or tendons caused by repetitive motions and constant use. They’re also sometimes called repetitive stress injuries.

Repetitive strain injuries are very common and usually affect your:

• Fingers and thumbs.
• Wrists.
• Elbows.
• Arms.
• Shoulders.
• Knees.

As their name suggests, repetitive strain injuries are caused by doing the same motion or activity repeatedly until it starts to hurt your body. Any motion or movement — from typing on a computer at work or placing a part on a product on an assembly line  — can cause a repetitive strain injury if you do it too often. Note that most repetitive stress injuries can be treated at home. 

Other illnesses that develop slowly include asbestosis, which results from continuous work-related exposure to asbestos, and black lung disease, formally known as pneumoconiosis, which occurs when coal dust is inhaled over long periods of time.

How to Start the Workers’ Compensation Process

You start the workers’ compensation claims process by filling out the claim form, known as the DWC 1, that your employer has given you. Under California law, there is a presumption that your illness or injury was caused by your work.  If you prevail on your claim, you will be entitled to:

• Up to $10,000 in treatment under medical treatment guidelines while the claims administrator considers your claim
• An increase in your disability payments if they’re late
• A process to resolve any disagreements between you and the claims administrator over whether your injury or illness happened on the job, the medical treatment you should receive, and whether you will receive permanent disability benefits.

Benefits To Which You Are Entitled 

Workers’ compensation insurance provides five basic benefits:

• Medical Care  – Paid for by your employer to help you recover from an injury or illness caused by work
• Temporary Disability Benefits – These can be used if your injury prevents you from doing your usual job while recovering
• Permanent Disability Benefits – These are payments if you don’t recover completely
• Supplement Job Displacement Benefits – These are vouchers to help pay for retraining or skill enhancement if you don’t recover completely and don’t return to work for your employer
• Death Benefits – These are payments to the spouse, children or other dependents if a worker dies from a job injury or illness

At some point during your claim evaluation, the claims administrator might take issue with some of your claims, or disagree with the recommendations of the treating physician. If this is the case, a qualified medical evaluator known as a QME may be introduced into the discussions for an evaluation of your claims. The person serving as a QME will be a doctor who has undergone a variety of training on the California workers’ compensation evaluation process. If you are not satisfied with the QME, your Santa Ana workers’ compensation attorney will help you understand if it makes sense to seek agreement with your claims processor on another medical evaluator known as an “agreed medical evaluator” to help with the claims process. 

Independent Contractors

Independent Contractors are not covered under California’s workers’ compensation law and regulations. If you have a question about whether you’re an employee or an independent contractor, it’s important to contact a Santa Ana workers’ compensation attorney to help you evaluate this question. 

There is no clear and explicit definition of this term. However, state labor agencies look at a couple of factors to determine whether a worker is an employee or an independent contractor. You should be aware that sometimes employers miscategorize workers as independent contractors in order to avoid the legal costs and liabilities that go along with having employees. A true independent contractor has control over how their work is done. You probably are not an independent contractor when the person paying you:

• Controls the details or manner of your work
• Has the right to terminate you
• Pays you an hourly wage or salary
• Makes deductions for unemployment or social security
• Supplies materials or tools
• Requires you to work specific days or hours.

If an employer does not have workers’ compensation coverage, it is punishable by either a fine of up to $10,000 or imprisonment in the county jail for up to one year, or both. Additionally, the state can issue penalties of up to $100,000 against illegally uninsured employers.

If you learn that your employer is not insured, it must nonetheless pay all bills related to your injury or illness. And note that you have the right to file a civil lawsuit against your employers.

If your employer does carry the proper insurance, workers’ compensation benefits are the only remedy to which you are entitled.

Contact the Law Offices of Benjamin Arsenian

To summarize, make sure that your supervisor is notified of your injury as soon as possible. If your injury or illness developed gradually, such as occurs with repetitive stress injuries, report it as soon as you learn or believe it was caused by your job. Reporting promptly helps avoid problems and delays in receiving benefits, including medical care. If you don’t report your injury within 30 days, you could lose your right to receive workers’ compensation benefits. Our team cares deeply about our clients.

Our legal practice focuses on accidents and personal injuries, and we work hard to get the best settlement possible for you. Whether you’ve been burned by chemicals in your workplace, tripped down your office’s unsafe staircase, or suffered a repetitive stress injury from typing in front of your computer all day, we can help you ensure that your worker’s compensation claim is properly handled. Contact us today for a free consultation.