How to Apply for Workers’ Compensation in Santa Ana

California’s workers’ compensation program exists to benefit employees injured in the course of their employment. However, applying for available compensation and benefits can be a difficult process filled with administrative burdens and less than transparent explanations of your rights to a claim. Learn how to apply for workers’ compensation in Santa Ana and understand other key details of the process, including possible appeal rights from our workers’ comp attorneys.

Step 1: Report the Injury to Your Employer and Get Emergency Medical Treatment

The first step to apply for workers’ compensation in Santa Ana is to report the injury to your employer. Injured workers have 30 days from the date of their injury to notify their employer about it. Reporting as soon as possible starts the claim process, which can lead to getting available benefits faster. Written notice of the workplace injury may be preferable to a verbal report for documentation purposes and for verifying that timely notice was given.

Seeking medical treatment is another key component of applying for benefits. State workers’ compensation laws protect your right to obtain reasonable medical care after a workplace injury and during the claim process. Initially, this care may have to come from the employer’s preferred list of doctors and healthcare organizations for the first 30 days after notice of a workplace injury.

Step 2: Complete and Submit a Workers’ Compensation Claim Form

After reporting the workplace injury, the employer should provide a workers’ compensation claim form (DWC-1). Workers must fill out the employee section of the claim form, which asks for certain personal information and details about the incident causing injury, such as the following:

  • The time and date of the injury
  • The address and description of where the injury occurred
  • A description of the injury and affected body parts

After completing the claim form, an injured worker will sign and date it before returning it to the employer. Returning the claim form to the employer is essential for protecting any right to benefits. The employer will complete the employer section of the DWC-1 and submit it to the workers’ compensation insurance provider. Obtain a copy of the fully completed claim form for recordkeeping.

Step 3: Wait for a Response from the Employer’s Insurance Provider on the Status of the Claim

Within 14 days of the Santa Ana employer submitting the completed workers’ compensation claim form, the insurance company should provide notice of the status of the claim. The claim adjuster must provide a letter of its decision to accept or deny the claim for benefits within 90 days of receiving the submitted claim form. Labor Code § 5402 places a presumption of a claim being compensable if the employer or claim adjuster does not deny the claim within the 90-day period.

Step 4: Consider Appeal Options for a Denied or Disputed Workers’ Compensation Claim

A claim for workers’ compensation benefits may require an additional appeal process if a dispute exists over the claim. For example, an employer could deny a claim altogether or deny certain benefits an employee requests under the claim. An employee can request a review of their denied claim by filing an Application for Adjudication of Claim to have an administrative law judge resolve the dispute.

Contact Us for Help Applying for Workers’ Compensation in Santa Ana

Our attorneys can help clients in every stage of their process of seeking available benefits after a workplace injury. If you or a loved one have questions about how to apply for workers’ compensation in Santa Ana, schedule a consultation with our team today.