Workers' Compensation Claims: What Injured Workers Need to Know

What Is Workers’ Compensation?

Workers’ compensation is a state-mandated insurance program that provides benefits to employees who are injured or become ill as a result of their job. In California, nearly all employers are required to carry workers’ comp insurance. The system is designed to provide medical treatment, disability payments, and rehabilitation services to injured workers without requiring them to prove their employer was at fault.

Types of Covered Injuries and Illnesses

• Acute workplace injuries: Injuries from a specific incident at work, such as falls, equipment accidents, lifting injuries, burns, or being struck by objects.
• Repetitive stress injuries: Conditions that develop over time from repetitive work activities, including carpal tunnel syndrome, tendonitis, and back problems from repeated lifting.
• Occupational diseases: Illnesses caused by exposure to hazardous substances or conditions in the workplace, such as asbestosis, hearing loss from noise exposure, respiratory conditions, and chemical exposures.
• Psychological injuries: In some cases, work-related stress, trauma, or harassment can result in compensable psychological injuries, though these claims face higher legal hurdles in California.

Workers’ Comp Benefits in California

California workers’ compensation provides several types of benefits:

• Medical treatment: All reasonable and necessary medical care related to the work injury, with no out-of-pocket cost to the employee.
• Temporary disability (TD): Payments to partially replace lost wages while you are recovering and unable to work, typically about two-thirds of your average weekly wage, subject to state minimums and maximums.
• Permanent disability (PD): Compensation for lasting impairments that affect your ability to work, calculated based on the nature and severity of the disability.
• Supplemental job displacement benefit: A voucher for retraining or skill enhancement if you cannot return to your previous job due to permanent restrictions.
• Death benefits: Payments to the surviving dependents of a worker who dies from a work-related injury or illness.

Employer Obligations

California employers are required to provide workers’ compensation insurance, report workplace injuries to their insurer, provide the injured employee with a claim form (DWC-1) within one working day of being notified of the injury, and authorize up to $10,000 in medical treatment while the claim is being investigated. Employers who fail to meet these obligations can face penalties from the state.

Why You Need a Workers’ Comp Attorney

While some straightforward workers’ comp claims are resolved without legal representation, many claims are disputed by employers or their insurance companies. Common disputes include denial of the claim, disputes over the cause of the injury, disagreements about the appropriate medical treatment, low permanent disability ratings, and premature termination of temporary disability payments. A workers’ comp attorney understands the complex regulations, can represent you at hearings before the Workers’ Compensation Appeals Board (WCAB), and works on a contingency basis — meaning no fees unless you receive benefits.

We Can Connect You With a Workers’ Comp Attorney

Leland Coontz III maintains relationships with experienced workers’ compensation attorneys in California. If you have been injured on the job and need legal help, we can provide a free referral at no cost or obligation to you.