Almost everyone employed in California is covered by the federal workers’ compensation program, even if they do not know it. With very few exceptions, all employers with at least one employee must participate in the program and buy insurance to cover their injured workers.
The worker’s compensation program provides free medical care for work-related injuries and pays a partial wage if your injury prevents you from working. Your employer or a local labor attorney could explain how to apply for workers’ compensation in San Diego.
Some people believe that workers’ compensation is a program for people who do physical labor or have dangerous jobs. However, worker’s compensation serves employees in almost every profession.
To apply for workers’ compensation benefits, the San Diego employee must recognize that their injury or illness is work-related and report it to their employer within 30 days. This report puts the employer on notice that an injury occurred and preserves the employee’s right to benefits. If the claim involves an injury that developed over time, California Labor Code §5412 requires the worker to file a report within 30 days of learning the injury was work-related or within 30 days of the date they first missed work due to the injury.
If a worker reports a job-related injury, the employer should provide the contact information for physicians who work with their workers’ compensation insurance provider. Except in emergency cases where a worker should seek treatment at a hospital emergency room, employees usually must seek treatment from one of the employer’s approved providers.
Even if an injury seems minor, it is important to get medical care. Symptoms might not be apparent at first, or a condition might worsen without treatment. In addition, if a worker did not seek medical attention promptly, the workers’ compensation insurer might contend that an injury was less serious than the employee asserts or was not related to their employment.
Most San Diego employers will give an injured employee applying for benefits a workers’ compensation form, but the employee could also download the form from the program website. The employee must fill out their portion of the form and then either hand deliver it or mail it to their employer. The employer must then complete their section, deliver it to their workers’ compensation insurer, and give the employee a copy of the completed form.
The insurer must begin paying benefits while it considers the validity of the claim. An injured worker is entitled to $10,000 of medical benefits in addition to any emergency treatment while an insurer reviews a claim. The insurer must begin paying the wage supplement within 14 days of receiving a medical report that the employee is unable to work.
Within 90 days of receiving the claim, the insurer must either accept or deny the claim. A worker will often hear nothing if the insurer accepts the claim. The insurer will continue to pay medical benefits and the wage supplement as long as the injury requires treatment and prevents the employee from working. If the insurance company denies the claim, the injured employee should consult a workers’ compensation attorney immediately to discuss the next steps.
If you are trying to recover from a work-related injury, you might be dealing with a lot of uncertainty. You do not need the additional stress of trying to navigate the workers’ compensation system alone, and many employers are not as helpful as they could be.
If you are not sure how to apply for workers’ compensation in San Diego, our knowledgeable attorneys would be happy to help. Missing deadlines could disqualify your claim, so call today.
