After a work-related injury, many people wonder what steps they need to take to file a workers’ compensation claim. The six basic steps are as follows:
First Aid
The first step is to take care of emergency needs, if the situation calls for it. If it is a medical emergency, call 911 or go to an emergency room. At the hospital let them know it is a job-related injury so you do not receive the bill. In a true emergency you do not need to notify your employer before seeking medical attention.
Report the Injury
When you can safely do so, notify your employer of the injury or illness. If there is not an emergency situation, notify your employer before seeking medical attention, as they will direct you to their insurance approved doctor/clinic. File a report with your employer within 30 days of the injury. If you file after 30 days you are not automatically precluded from receiving benefits, but you will face more challenges and delays. If the injury or trauma developed over time, report it as soon as you realize the injury was caused by your job. Your employer must give or mail you a Workers’ Compensation Claim Form (DWC 1) within one working day after you report your injury or illness. If your employer does not, or will not, give you one, you can obtain one from an Information & Assistance officer employed by the state, find one online at the Division of Workers Compensation website here: https://www.dir.ca.gov/dwc/DWCForm1.pdf , or contact a workers compensation attorney like those at Injury Compensation Law PC to fill it out.
Fill out your portion of the DWC1, and promptly return it to your employer. Your employer will fill out their portion and submit it to a claims administrator (also called a claims examiner or claims adjuster).
Go to the Doctor
Your employer will direct you to their insurance approved doctor/clinic. You can pre-designate a doctor of your choosing, but this must be done in writing and approved before the injury or illness. Do not wait too long to go to the doctor, and just like in the emergency room, be sure to tell them it is a work-related injury so you do not get the bill. Your employer must pay for medical care for job-related injuries whether or not you miss time from work.
Give a thorough report of all your symptoms to the doctor, even if they seem less important to the main injury. If a minor injury develops into something more serious but is not on the doctor’s report, your employer may try to argue that the injury was not work related.
It is important to follow the direction of your doctor in returning to work and normal activity. Do not let your employer dictate what you are capable of (or required to do) if your doctor has given other advice. Do not return to work before your doctor deems you ready, even if you are receiving pressure from your employer. If your employer threatens to discipline or fire you because you are following your doctor’s orders, contact us at Injury Compensation Law.
Keep Good Records
The California Department of Industrial Relations recommends that you keep records of everything including doing the following:
- taking notes of all conversations you have with anyone involved in your claim;
- tracking your medical condition and how it affects your ability to work;
- submitting a written request to the claims administrator for copies of all medical reports and other documents;
- submitting off work/work restrictions reports to your employer/HR;
- saving pay stubs and time sheets from before and after the injury to show income and the dates you did and did not work; and
- maintaining a record of any out-of-pocket expenses that could be covered by workers’ compensation such as travel costs and prescriptions
Apply for Benefits with EDD
File a claim with the Employment Development Department (EDD) for state disability insurance (SDI) benefits - NOT unemployment benefits (that can hurt your case). You usually cannot receive both workers’ compensation and State Disability Insurance at the same time but you may be able to receive SDI benefits if your employer denies or delays workers’ compensation benefits. Since insurance companies have up to 90 days to accept or deny your claim, you will likely need to apply for EDD SDI during that time until the claim is accepted and workers compensation insurance benefits take over. Remember that at no time can you receive double benefits or benefits and full pay.
Contact an Attorney
An attorney will help you stay up on deadlines, file all the necessary documents, manage hearing dates, appeal insurance denials, and a variety of other things. Most importantly an attorney will be your advocate while you rest and recover. Managing a workers’ compensation claim while recovering from an injury can be stressful. The attorneys here at Injury Compensation Law are here to help relieve some of that stress. We are here to protect your rights. Contact us today for a free consultation.
