Our list of common questions is regularly updated. If your question isn’t listed below or if you would like to know more about what’s involved in the workers’ comp process, feel free to contact a Barsoum Law team member at 877-299-1555 or info@barsoumlaw.com.
What Is Workers’ Compensation?
The state government affords employees injured while working the ability to have workers’ compensation benefits cover related financial losses. Workers’ compensation insurance protects workers from the sometimes crippling medical costs of work-related injuries, and protects employers from any serious financial loss in the event of a lawsuit.
Your employer should be able to provide you with all the proper forms needed to file a workers’ compensation claim if requested. But you can always download the appropriate forms from your local government website. In California, that would be the Department of Industrial Relations’ Division of Workers’ Compensation.
Once your claim has been filed, the insurance company decides whether to approve or deny the claim. If approved, the exact amount of compensation you will receive is finalized. And your treating physician will determine the severity of your disability, how much treatment is required, and whether you can safely return to work.
If denied, you can still appeal the decision.
Typical workplace injuries include:
Back Pain & Injury
Neck Pain & Injury
Spinal Cord Injuries
Broken Bones Injuries
Head Injuries
TBI
Wrongful Death
Loss of Limbs
Paralysis
Internal Bleeding
Road Rash
Scars
Whiplash
Who Pays for Workers’ Compensation Benefits?
Not you! Employees do not have to pay for their own benefits.
Even if the injury or illness seems minor, your employer is required to pay for any medical treatment regardless of whether your claim is accepted or denied. This extends to pre-existing conditions that were aggravated by the nature of your job or job-related accident (think hearing loss, PTSD, and muscle strain). And in California, “medical treatment” extends to chiropractic needs, physical therapy, and occupational therapy as well.
Do I Have Workers’ Compensation Insurance?
Most employees have workers’ compensation insurance through their employer.
In California, any business with one or more employees is required to provide coverage. This means that just about every employee (including temporary, part-time and sometimes even contractors) are eligible for workers’ compensation.
Even if you are partly to blame for the injury, if your working conditions contributed to any damage or disease, your employer is still required by state to provide workers’ comp. There are some obvious exceptions to this, such as committing a crime, violating company policy, or working while drunk or high. But aside from that, if you’ve sustained a sudden injury or cumulative illness while on the job, you are entitled to workers’ compensation.
When do I report a workplace injury?
As soon as possible!
Keep in mind that simply telling your employer and colleagues of the injury is not sufficient. You will need to formally file a Workers’ Compensation Claim Form, also known as a DWC-1. The form asks you to describe the nature and severity of your injury, and which part of the body was affected. The description you give will be compared to the treating doctor’s diagnosis, so it’s crucial that you are as accurate as possible. If you wait too long to file for workers’ comp, you could lose important benefits.
How much time do I have to file a workers’ compensation claim?
As long as you file a claim within one year from the date of your job-related injury or illness, you are entitled to benefits. But any workers’ comp attorney will advise you report your injury ASAP.
What benefits are available under workers’ comp?
Broadly speaking, you are entitled to compensation and medical treatment when injured on the job but the exact amount and duration of compensation you may receive depends on the nature of your work-place injury or illness.
There are many types of benefits available to you under California law. And you only have to qualify for one of them to start receiving compensation. An experienced attorney will be able to explain the different factors that come into play when deciding exactly how much your workers’ compensation claim is worth.
What if I’m injured while working from home?
Yes! If you are injured from a mandatory WFH order (as was the case for many employed during the COVID-19 pandemic) you are entitled to workers’ compensation. If the claim is approved, you will receive benefits in the same way you would if you were injured while at your regular work location.
Can I get fired for filing a workers’ comp?
Employers CANNOT fire you because you filed for workers’ comp.
Even bound by the Americans with Disabilities Act (ADA) and Equal Employment Opportunity Commission(EEOC), if a worker’s disability makes it impossible for them to do anything within the company, then it is legal for employers to let them go. That being said, if an employer simply doesn’t want to accommodate an injured employee, or in any way pressures them to leave because of their disability, that’s injury harassment. And it is never acceptable. In the event that you are lawfully fired, you will still retain your workers’ compensation benefits.
Can I go to my own doctor for treatment for my work injury?
California law has certain rules about how you can select (and change) your treating doctor depending on whether your employer has contracted with a health care organization (HCO) or established its own medical provider network (MPN).
If your employer DOES NOT have an HCO or MPN contract, you may be able to choose your personal primary care physician if certain conditions are met:
You have health care that covers treatment outside of work-related injuries or illnesses
Your primary care physician agreed to treat you for work-related injuries or illnesses IN ADVANCE
You gave your employer notice of predesignation BEFORE being injured. “Predesignation” is simply declaring that your personal doctor will also be your treating doctor in the event of workplace injury or illness. File DWC form 9783 with your employer to make a predesignation.
Even if your employer has contracted with an HCO, you can still predesignate and choose your primary care physician to be your treating doctor. But it will likely be a more complicated process. If your employer DOES have an HCO or MPN contract and/or If you have not chosen a doctor before the injury occurred, your choices are limited.
Can I return to work after my injury?
Absolutely! The only exception is if a doctor gives you permanent work restrictions (based on the nature of your disability) and your employer is unable to accommodate those restrictions. But if that’s the case, your employer is still obligated to pay for any training or education (up to $6,000) needed for you to work in a different position. In California, you can also receive up to $5,000 to help pay for regular monthly expenses while you are being trained and/or in school.
How do I settle my workers’ compensation case?
There are 3 ways to settle your workers’ comp case:
Stipulation with Request for Award – This is an agreement between you and your employer’s insurance company as to what benefits you will receive for your workplace injury treatment. The agreement is approved by a judge and you then receive said compensation (typically in biweekly payments).
And if needed, you can reopen your case up to 5 years from the date of injury if a doctor finds that you have increased permanent disability and will require additional treatment.
Compromise and Release – This turns your workers’ compensation into a single, definitive payment. Your attorney will negotiate with the insurance company to assign your current injury treatments and possible future medical treatments (should the disability worsen) a monetary value. You are paid that amount, then the case is officially closed, and the insurance company is not liable for any future payments (even if your injury or illness requires more medical treatment than anticipated).
Go to Trial – Contrary to popular belief, trial is your last resort and will only occur if there’s a dispute between you and your employer that your attorneys cannot resolve. You will likely have to undergo a QME evaluation, where a certified doctor from the Division of Workers’ Compensation (DWC) Medical Unit examines your workplace injury and determines the extent of your disability.
A judge will have the final say concerning the amount of compensation you receive. But otherwise, the outcome of the trial will typically proceed the same way a Stipulation with Request for Award would: you receive an agreed upon amount of compensation and you will still be able to reopen the case in the future.
Do I need an attorney?
Legal background or no, any employee who suffers from a job-related injury or illness is entitled to benefits. But a legal background definitely helps. An experienced workers’ compensation attorney can walk you through the entire process, answer any questions or concerns, and ensure that you receive the full amount of compensation you need.
If you have suffered a work-related injury or illness, Barsoum Law can and will help. We have represented thousands of injured workers throughout California the past 25 years. We offer a personal focus and individualized care that large corporate firms do not. Our multilingual, multicultural team is dedicated to making sure you obtain the compensation you deserve.
Contact us today at 877-299-1555 or info@barsoumlaw.com to schedule a consultation with a member of our team.
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