Workers’ Compensation Insurance benefits
What to do after workplace injury or illness
Your WC claim begins…
Deadlines to look out for…
- Civil Rights
- Personal Injury
- Workers' Compensation
Report the injury to your employer by telling your supervisor right away. If your injury or illness developed over time, report it as soon as you learn or believe it was caused by your job.
Reporting promptly helps prevent problems and delays in receiving benefits, including medical care you may need. If your employer does not learn about your injury within 30 days and this prevents your employer from fully investigating the injury and how you were injured, you could lose your right to receive workers’ compensation benefits.
Get emergency treatment if you need it. Your employer may tell you where to go for treatment. Tell the health care provider who treats you that your injury or illness is job-related.
Fill out a claim form and give it to your employer. Your employer must give or mail you a claim form within one working day after learning about your injury or illness. If your employer doesn’t give you the claim form you can download it from the forms page of the DWC website.
A medical provider network (MPN) is a group of health care providers set up by your employer’s insurance company and approved by DWC’s administrative director to treat workers injured on the job. Each MPN includes a mix of doctors specializing in work-related injuries and doctors with expertise in general areas of medicine. If your employer is in an MPN your workers’ compensation medical needs will be taken care of by doctors in the network unless you were eligible to predesignate your personal doctor and did so before your injury happened.
If you have a work-related injury or illness, your employer is required by law to pay for workers’ compensation benefits. You could get hurt by:
One event at work, such as hurting your back in a fall, getting burned by a chemical that splashes on your skin or getting hurt in a car accident while making deliveries.
Repeated exposures at work, such as hurting your wrist from doing the same motion over and over or losing your hearing because of constant loud noise.
Your primary treating physician (PTP) is the physician with the overall responsibility for treatment of your injury or illness. Generally, your employer selects the PTP you will see for the first 30 days, however, in specified conditions, you may be treated by your predesignated physician or medical group. If a physician says you still need treatment after 30 days, you may be able to switch to the physician of your choice. Different rules apply if your employer is using an HCO or a medical provider network (MPN).
Your local I&A officers are a great resource and their services are free. They are not there to act on your behalf as an attorney would, but they’ll help you understand how to act on your own behalf. Attend a free seminar for injured workers at a local DWC district office for a full explanation of workers’ comp benefits, your rights and responsibilities. You can also make an appointment with an I&A officer and speak to them privately at your convenience.
In addition, there is a lot of information on the I&A page of the DWC’s website. Check out the fact sheets and guides for injured workers. The fact sheets provide answers to frequently asked questions about issues affecting your benefits. The guides will help you fill out forms you may need to get a problem with your claim resolved at the local DWC district office.
Yes. Giving the completed form to your employer opens your workers’ compensation case. It starts the process for finding all benefits you may qualify for under state law. Those benefits include, but are not limited to:
MARIO H vs. MYSTIC GARDENS
GARDENER FELL INTO EMPTY SWIMMING POOL WHILE TRIMMING TREE.
CARLOS M vs.COMM-FAB, INC.
INJURED WORKER SUSTAINED SEVERE INJURY TO FINGERS.
ABDEL H vs. VALUE CARS
DENIED CASE. CATASTROPHIC INTERNAL AND SPINAL INJURIES. THIS CASE WAS LITIGATED ALL THE WAY UP TO THE CALIFORNIA SUPREME COURT. WE WON! 100% PERMANENT DISABILITY AND LIFE-TIME MEDICAL.
SETTLEMENT: PENDING SEVEN-FIGURE (TO BE REVISED SOON).
JARED O vs. KOETSIER DAIRY
DRIVER WHILE IN COURSE AND SCOPE OF EMPLOYMENT STRUCK BY ANOTHER VEHICLE. OUR FIRM HANDLED BOTH THE WORKERS’ COMPENSATION AND PERSONAL INJURY CASES.
NESTOR E vs. PACIFIC PARADISE NURSERY, INC.
LITIGATED DENIED CASE. WON! AT FAULT LANDSCAPE LABORER INJURED IN CAR ACCIDENT.
FAUSTINO B vs. MIKE ETCHANDY FARMS, INC.
DENIED CASE. WON! FARM WORKER INVOLVED IN CAR ACCIDENT WHILE ON HIS WAY TO WORK.
SILVESTRE D vs. TG ROOFING AND ROOF REMOVAL
ROOFER INJURED BACK
VICENTE L vs. NEW CENTURY INDUSTRIES, INC.
HEAVY STEEL ROLL FELL ON INJURED WORKER’S LEG. WORKERS’ COMPENSATION AND THIRD-PARTY CASE.
$1,650,000.00 FOR CIVIL CASE AND $350,000.00, NEW MONEY, FOR WORKERS’ COMPENSATION CASE. $2,000,000.00 COMBINED SETTLEMENT.
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