You have rights. Do not become a victim to the the insurance company’s dirty tricks. Protect those rights and demand justice.
If you are injured while working, the very first thing you need to do is
- report your injuries to your employer, and then
- promptly seek medical care for your injuries.
Those two things must be done to preserve your rights under workers’ compensation laws. The next step is to read the guide below
What is workers’ compensation?
Workers’ Compensation is a system that replaces the traditional tort system for employers and employees. “Tort” is an old term, but it is your basic personal injury case where you are driving in a car, and someone else rear-ends your vehicle, causing a collision and injuries to you. You make a claim against their insurance company and if both parties do not come to an agreement, a lawsuit is filed.
Well the workers’ compensation system gets rid of that. You are not allowed to sue your employer for work related injuries, except in a few specific situations. In exchange for losing the right to sue your employer, you are guaranteed benefits for the injuries you suffer. That is the tradeoff. These benefits include wage replacement and medical care.
If you get hurt or injured while on the job, in California, your employer is required under the law to pay for workers’ compensation benefits.
You can get hurt by any number of ways, including:
- A single event at work. For example, you are walking down the hallway and fall, hurting your back. Or, you work with chemicals in a lab and it splashes on your skin. Or you can be driving, delivering packages when someone hits your vehicle, injuring you.
- Repeated/multiple exposures at work. These can result from prolong, repeated activities. You get carpal tunnel because of typing every day. Your hearing is going bad because of constant loud noise. You experience chronic pain in your lower back due to lifting heavy boxes all day.
Workers’ compensation will also covers some, but not all, stress-related (psychological) injuries caused by your job.
What are the benefits provided by the Workers’ Compensation system in California?
They can include:
- Medical Care. Your benefits include visits to health care professionals to help you recover from illness, or injury at work. This will include doctor visits, hospital stays, tests, medicine, medical equipment, and also travel costs that are necessary to treat your injury.
- Temporary Disability Benefits. If you miss time at work because of your injuries, you can receive benefits to help you.
- Permanent Disability Benefits. If you suffer a permanent loss of physical or mental capacity that prevents you from working, you can receive disability benefits.
- Supplemental Job Displacement Benefit. Available for those who need retraining or skill enhancement because of a permanent disability, and you don’t return to your employer, nor does your employer offer you work.
- Death Benefits. If you die because of a job injury or illness, payments will go to your family.
Deadlines in Workers’ Compensation cases
Missing a deadline can be catastrophic for your case. There are two major deadlines you must be aware of:
- You must report your injury to your employer within 30 days
- You must apply for workers’ compensation benefits within 1 year
If you are injured at work you must report it to your employer within 30 days. California Labor Code Section 5400 states:
Except as provided by sections 5402 and 5403, no claim to recover compensation under this division shall be maintained unless within thirty days after the occurrence of the injury which is claimed to have caused the disability or death, there is served upon the employer notice in writing, signed by the person injured or someone in his behalf, or in case of the death of the person injured, by a dependent or someone in the dependent’s behalf.
In plain english:
- You have 30 days from the date of the accident/injury to report it to your employer.
- The Notice must be in writing, signed by you or your representative.
- If the injury causes death, a dependent or their representative must send this notice.
If you do not provide notice to your employer, you could be prevented from receiving benefits, unless you can prove the employer had knowledge of the claim from other sources (as discussed below).
Read more about Filing a California Worker’s Compensation Claim
An exception to the notice requirement under 5400 if employer has knowledge of the claim
Section 5402 of the Labor Code states that if an employer, or anyone acting on behalf of the employer has knowledge of the injury, or knowledge that you will assert a workers’ compensation claim, this will be equivalent to receiving written notice required under Section 5400.
What this means is if you fail to submit the written notice required in Section 5400, but your employer knows of the injury anyway, or knows you will be asserting a claim, then the requirement has been satisfied. For example, you complained to your boss on numerous occasions that your back has been hurting from lifting boxes. Or you slipped and fell, and your co-worker ran to tell your employer.
But I would not risk having to prove your employer knew about the claim. It is better to play it safe and send written notice.
What about injuries and disabilities that happen over time, like carpal tunnel syndrome?
If your injury is of the type that happens over time from repeated activities or conditions, then you should report the injury/disability when you first suffer a temporary disability (take time off work) and realize it is caused by your job. California Labor Code Section 5412:
The date of injury in cases of occupational diseases or cumulative injuries is that date upon which the employee first
suffered disability therefrom and either knew, or in the exercise of reasonable diligence should have known, that such disability was caused by his present or prior employment.
What happens if no notice was given, and no exception applies?
There is still a chance to apply for, and receive workers’ compensation benefits. If you miss the deadline to report the claim, your employer now has an affirmative defense: that your failure to notify them of the claim misled them and caused them prejudice. This is where a skilled workers’ compensation attorney comes in, to provide evidence that your employer was neither misled nor harmed.
DWC-1 Workers’ Compensation Claim Form
Within 1 year of your injury, you must file a workers’ compensation claim form. In fact, you can file this form within 30 days of your injury and satisfy both deadlines at once.
Workers’ comp insurance company denied my claim? Do I need a San Diego Workers’ Compensation Attorney?
Then you can appeal this decision with the California Workers’ Compensation Appeals Board. You are not required to bring an attorney to this hearing but if your injuries are significant, you should consult with one right away.