There is a claim for workers compensation in California.
If you become injured at your job in the state of California, you may be able to get benefits from your employer to compensate for medical treatment and the time spent not working during your recovery.You must report the injury to your employer within 30 days if you want to receive workers' compensation benefits.To begin receiving your benefits, you need to complete the necessary documentation.There are more procedures to follow if your claim is denied.
Step 1: If needed, get immediate medical care.
Emergency care is your first priority if the injury is serious.If less serious, get first aid at the site and then see your doctor.Inform the hospital or doctor if the injury is related to work.
Step 2: You should report the injury to your employer.
If the injury was from a single accident or incident, you should report it as soon as possible, but no later than 30 days after the accident.You may not be eligible for compensation benefits if you fail to report within that time.If your claim is based on a developing condition rather than a single injury, but you still believe it is work related, you must report the condition to your employer within 30 days.
Step 3: Continue to receive medical care.
The law requires your employer to provide medical care for a work-related injury.If the injury was necessary for a work related injury, your doctor may not bill you for this care.You may be able to get compensation for travel costs to receive medical care.The state's expense form can be found at http://www.dir.ca.gov/dwc/WorkersBenefits.htm#MileageRates.The mileage rates and claim forms have changed over time, so be sure to use the correct one.
Step 4: Get a claim form.
The form is referred to as DWC-1.Your employer should give you a copy of the form within a day after you report your injury.You can get a copy from the DWC website if the employer doesn't do that.You can call the DWC Information and Assistance Unit if you can't get the form online.
Step 5: Carefully complete the DWC-1.
Only the employee section of the form is complete.If you fill out this form, you will be asked to provide the following information: Name Address Date and time of injury Address and description of the location where the injury occurred.It's good to be descriptive.If you slip on a puddle in the bathroom, you should describe the location as "bathroom floor, puddle of water." Injury you sustained and the body part affected.Again, be descriptive and complete.A broken ankle is a better response than a broken bone.
Step 6: The DWC-1 should be submitted to your employer.
Before you turn it in, make sure you keep a copy of the form.Your employer is required to complete the Employer section of the form and return a signed copy to you within one working day.If you don't get the Employer's copy, you should ask about it.The copy can be turned in by hand or by mail.If you are mailing the form, you should use certified mail, return receipt requested, so you have a copy of the date that you sent it and the time it was received.
Step 7: Wait to hear from the company.
The form is sent to the insurance company after the employer completes the form.You will get a letter from the insurance company about the status of the claim within two weeks.
Step 8: Wait for the decision from the employer.
The claim is presumed to be accepted if the employer doesn't inform you of it within 90 days.
Step 9: You should get the medical care that you need.
The first of five basic benefits is reasonable and necessary medical care for an injury or condition.You shouldn't get bills for this care.You should remind the doctor or hospital that this is a workers' compensation claim and that the bills should go to your employer.Your employer can help correct the error if you notify them.
Step 10: Receive temporary disability benefits.
If you were unable to work, your employers will cover your lost wages.If you did not lose work time, this may not apply.
Step 11: Receive benefits for permanent disability.
If your injury is permanent, you will get permanent disability benefits from your employer.The amount of PD benefits is set by law and is based on a variety of factors, such as the date of your injury and how much you can't work, as determined by a doctor's age and occupation.
Step 12: Supplemental job displacement benefits can be received.
The voucher is up to $6,000 and can be used for any additional education or training you need to get back to work.
Step 13: Receive death benefits as spouse or dependents.
If the death of an employee is caused by an injury, then the employee's spouse or dependents are entitled to receive payments.The number of dependents and their ages are used to calculate the amount of payments.
Step 14: If there are disagreements about benefits, see a qualified Medical Evaluator.
You are entitled to see a qualified Medical Evaluator if you disagree with the level of benefits or the duration of care that you need.This doctor has training in reviewing workers' compensation claims.
Step 15: You should review your employer's decision.
Your employer has 90 days to tell you that your claim has been denied.The employer won't be providing benefits for your injury.If you want to proceed further, you should consider hiring an attorney.
Step 16: There is a qualified medical evaluator.
You are entitled to see a Qualified Medical Evaluator after learning that your claim was denied.This doctor has training in reviewing workers' compensation claims.
Step 17: You must complete and submit the Application for Adjudication of Claim form.
If you still believe that you have a valid claim after the independent evaluation, you can file a case with the DWC.The Application for Adjudication of Claim form is required to file a case.The form is available online at http://www.dir.ca.gov.It asks for the same information as before, but with more information about the incident and your injuries.You need to submit the completed form to the DWC office in the county where you were injured.The completed Application for Adjudication form must be delivered to your employer.
Step 18: You can get a case number.
A notice in the mail will confirm the filing of your case after you submit your Application for Adjudication.The case number will be used on any further correspondence.You will be given instructions on how to proceed with the case.
Step 19: Prepare for the hearing by hiring an attorney.
If you haven't hired an attorney yet, you should consider doing so.It can get complicated when you enter a time of preparation for trial.Depending on the seriousness of your claim, you should consider the extra help if you need it.
Step 20: To get a hearing, you have to file a declaration of readiness.
You can get a form on the DWC website that tells the office you are ready to go.You should be prepared to argue your case before a judge if you have spoken to any witnesses.
Step 21: You should attend the hearing.
You and your attorneys will appear before a judge at the hearing.This is more of a meeting than a trial.The judge will try to reach a settlement with both of you.The judge will set a date for a future trial if that is not possible.
Step 22: Prepare for trial.
You will have to give documents to the employer, prepare witnesses, and define the issues that are in dispute.
Step 23: Receive a decision after attending the trial.
At the trial, you will present your case to a different judge than you did at the previous conference.You and your employer will have the chance to present your side of the issue, question and cross-examine witnesses, and explain your view regarding the claim.Within a few weeks after the trial, the judge will issue a written decision.
Step 24: There is a guide for injured workers.
You can download the entire Guidebook online at http://www.dir.ca.gov/InjuryWorkerGuidebook/
Step 25: There is a seminar on workers compensation.
There are seminars at division offices in California each month.You can get more information by calling 800-736-7401.You will learn about your rights at the workshop.
Step 26: You can review the site.
Links to current legislation, information about programs, and contacts to various state agencies can be found on the DWC's web site.If you've been injured on the job, this is a good reference.