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If you need help filing a workers’ compensation claim in California or the insurance company has undervalued or denied your claim, a workers’ compensation attorney from KLT Law Group can help you. Call (818) 507-8525 today for a free consultation.
Injuries to Report for Workers’ Compensation in California
If you suffer any on-the-job injury that keeps you out of work for more than three days, you may qualify for disability payments, per California Labor Code § 4652. Although not an exhaustive list, injuries covered by workers’ compensation may include:
Occupational Illness or Injury
According to The Centers for Disease Control and Prevention (CDC), various illnesses can result from on-the-job exposure, including everything from asthma, influenza, and allergies to cancer, cardiovascular disease, and Lyme disease. Workers can also experience hearing loss, skin ailments like dermatitis, or mental health disorders that qualify for workers’ comp.
If you primarily encountered the ailment or injury’s cause at your workplace, and not at your home or another space you frequent, you should report your injury to qualify for workers’ compensation.
Repetitive Injury
If your work requires you to perform the same motion repeatedly, you may develop an injury over time.
According to Cleveland Clinic, common repetitive strain or motion injuries include carpal tunnel syndrome, tendonitis, tennis elbow, shin splints, stress fractures, herniated discs, and chronic back or knee pain.
Accidents
Malfunctioning pieces of equipment, falling on a slippery floor, and many other accidents can cause sudden injury during your workday.
If you’re unsure whether your injury qualifies for workers’ compensation, an attorney familiar with California workers’ compensation law can help with your case.
Circumstances That May Disqualify You From Workers’ Compensation
According to California Labor Code § 3600, if you are injured under certain circumstances while on the job, you may not qualify for workers’ compensation in California. These situations may include:
- Injury caused by intoxication
- Self-inflicted injuries
- Intentional fighting
- Voluntarily participating in an activity not related to your work duties (like playing on a company sports team after work hours)
- An injury caused by a third party
- Injury sustained while committing a crime
Additionally, mental health ailments not directly linked to your job may not qualify for workers’ compensation.
Individuals Who May Not Qualify for Workers’ Compensation
California Labor Code § 3352 states that certain individuals do not qualify for workers’ compensation. Examples include but aren’t limited to:
- Someone employed by their spouse, child, or parent
- Someone working in exchange for aid, such as food and shelter, rather than pay
- Unpaid volunteers
- Independent contractors (with some exceptions)
There are caveats and exceptions to this list. It’s safest to check with an attorney to see if you qualify for workers’ compensation rather than assuming you do not.
How to Pursue Workers’ Compensation After an Injury
Some injuries are immediately apparent. If someone is rounding a corner while pushing a metal cart and rams into you, breaking your foot, you know you’re injured.
Other workers’ compensation injuries or illnesses may take time to manifest. If you develop hearing loss from exposure to loud noises or realize your back always aches because you constantly lift heavy objects, you know you were injured because of your job, but the injury did not occur suddenly.
The steps for reporting a work-related injury include the following:
- Per the California Department of Industrial Relations (DIR), you have 30 days from the date of the injury or the date you first became aware of it to report your work-related illness or injury to your employer. If you do not report it to your employer within this timeframe, you may not qualify for workers’ compensation. You then have one year to file a workers’ compensation claim, according to the California Department of Social Services.
- Upon receiving your written notice, the insurance company has 90 days to respond. If they don’t do so, it will be automatically approved, and you will begin receiving benefits, according to the DIR.
- Do not wait for a response to get medical care. If it isn’t an emergency, you may need to visit a preapproved healthcare provider initially, but at some point, you should be able to see a different doctor if you wish.
- If the insurance company denies your claim, you have the right to appeal. Your lawyer can help you with this process.
Workers’ Compensation Benefits You May Receive for Your Injury
If the DIR accepts your claim, the benefits you may receive include:
- Medical care necessary for the treatment of your injury, such as medical devices, equipment, prescriptions, travel, specialists, and surgery
- Temporary disability benefits, which are 2/3 of your gross pay, up to a maximum amount allowed
- Permanent disability benefits, which are based on your inability to recover from your injury fully—how much you receive and for how long depends on factors specific to your injury
- Supplemental job displacement benefits, which pay for training in a new industry if you have a permanent partial disability
- Death benefits if your loved one died from a work-related illness or injury
A workers’ compensation attorney can help you identify all the benefits you qualify for due to your injury.
Additional Benefits From the Subsequent Injuries Benefits Trust Fund (SIBTF)
If you were already living with an impairment or disability when you were injured, and the new injury has now given you a permanent disability rating of at least 70%, you may apply for additional benefits through the SIBTF. Your lawyer can help you determine if you qualify for this program.
When Your Employer Does Not Carry Workers’ Compensation Insurance
According to the California Contractors State License Board, California requires that all employers with at least one employee carry workers’ compensation insurance. However, not all employers follow this rule.
If you are injured on the job and discover that your employer is not insured, you may still apply for benefits through the Uninsured Employers Benefits Trust Fund (UEBTF). According to the DIR, if the Workers’ Compensation Appeals Board has awarded you benefits, you can file a claim with the UEBTF. It is a complicated process, but it’s worth it if you can recover the benefits you deserve.
KJT Law Group Fights for Injured Workers’ Rights
Our workers’ compensation attorneys will fight hard to get you every benefit you deserve. We believe no case is too small and no odds are too daunting for us to come out swinging on your behalf.
Schedule your free case consultation today by calling (818) 507-8525, and rest easy knowing that we work on a contingency basis. You will pay no attorney’s fees unless we win your case, so you have nothing to lose.
