Workers Compensation FAQ's

What do I do if I am injured on the job?

Generally, whenever you are injured on the job, your injury is covered under the WORKER'S COMPENSATION system. The Worker's Compensation Appeals Board (WCAB) is the exclusive court for all industrial injuries. Generally, you cannot sue your employer in Civil Court. A worker's compensation claim is your only remedy with some exceptions. For example, if somebody, other than your employer, is responsible for your injury, you may sue that person in civil court or if you were injured as a result of defective equipment, tools or machinery, you may sue the manufacturer, retailer or distributor of that product. This office will not normally handle the Third Party case unless there has been an express written agreement.

As soon as you have been injured, you should immediately report it to the employer, Within ONE DAY, the employer is required to provide the worker with a claim form.

What happens if I don't report the injury until after I have been laid off or terminated?

A claim which is not filed until after the worker has been terminated or notified that he is about to be terminated is not valid unless you can show that you reported the injury to the employer before termination, or there are medical records which document your injuries before termination.

How much money will I receive while I am off work?

During the period the treating doctor states that you are unable to return to work, you are entitled to receive temporary disability at the rate of 2/3 of your gross pay per week, payable at least every (2) weeks. If your injury occurred after January 1, 2009, the minimum you can receive is $143.75 and the maximum is $958.01. For injuries after 1/1/08, these benefits are payable no more than 240 weeks within a period of 5 years from the accident. If your injury occurred prior to that date, other rules apply and you may receive money for a shorter time period.

In the event the insurance company refuses to pay you temporary disability, you may obtain State Disability Benefits (SDI) from the California Employment Development Department (EDD). However, a doctor must confirm you are unable to work and he/she must fill out the appropriate forms from EDD.

Am I required to obtain treatment with the Employer's doctor?

Your employer is obligated to provide you with all reasonable and necessary treatment for your injury. Your employer is required to notify you of your rights under the Medical Provider Network (MPN) if there is one. If your employer has established one and has notified you of this at the time of your injury, then you must see their doctors. However, if they fail to provide you with a doctor or fail to notify you of your rights under the MPN system, there may be instances when you can see your own doctor or a doctor that your attorney has referred you to.

In addition, if prior to your injury, you notified your employer in writing that you designate your personal physician, that doctor can treat you from the date of the injury.

Whenever a doctor's appointment is made for you, YOU MUST KEEP THAT APPOINTMENT. In many cases, if the insurance carrier has made an appointment for you, and you miss it, they may cut off your benefits. If you have a question on whether or not you should attend such an appointment, please call this office immediately.

The employer, in addition to paying the doctor's bills, must pay for any reasonable and necessary other expenses such as medicine, crutches, surgical supplies, x-rays, and mileage to and from the doctor's office. PLEASE KEEP A RECORD OF MILEAGE TRAVELED AND A RECORD OF ANY EXPENSES YOU HAVE. You may be entitled to reimbursement.

What if my Employer terminates me because I was injured on the job?

It is illegal in California to fire somebody or discriminate against a worker as a result of their industrial injury. Labor Code 132 (a) provides for an increase in your workers compensation benefits by one half up to a maximum of $10,000, costs up to $250, reinstatement of your job, and reimbursement for lost wages and benefits. However, simply because you are fired while on disability does not entitle you to these benefits, you must prove that the termination or discrimination occurred because of your industrial injury. The employer is entitled to terminate you if it is necessitated by the realities of doing business.

Do I need an Attorney?

Many injured workers wait until it is too late before hiring or consulting an attorney. Because the insurance company does not always have the injured workers interest as their priority and because the rules are complex, it would be a good idea to consult an attorney. The initial consultation is free and there is no charge until the case is settled or an award given. Normally, the fees are in the 12% to 15% range. If there is no settlement or award of compensation there is no charge.

What if my doctor releases me to modified work, but none is available?

You should always try to return to work, if you are able to do so without injuring yourself further. If the employer is not willing to provide you work within the restrictions given by the doctor, you are considered to be temporarily disabled from your usual and customary duties and disability benefits should be paid by the insurance company. If you refuse to return to work, your temporary disability benefits may be cut off.

Can I get a retraining or vocational rehabilitation if I cannot return to my old job?

For dates of injury after January 1, 2004, the Job Displacement Benefit (JBD) program allows distribution of education vouchers up to $4,000.00 for disabilities less than 15%, up to $6,000.00 for disabilities between 26-49%, and up to $10,000.00 for disabilities between 50-99%. Under this system, injured workers may be eligible for a JBD if they do not return to work within 60 days of the termination of temporary disability. Benefits include nontransferable vouchers for "education-related retraining, or skill enhancement, or both, at state approved accredited schools".

If your employer has 50 or more employees and does not offer modified work within 60 days of you becoming permanent and stationary, or has reached maximal medical improvement, your permanent disability rate can be increased by 15%.

If your employer offers you modified work, your permanent disability amount decreases by 15%, regardless of whether you accept or reject it. The job must last for at least 12 months, be within 85% of your wages and be within a reasonable commuting distance.

What types of settlements are there?

The first method of resolving your case is by Stipulation of Findings and Award. This occurs when the parties agree that you will need future medical care and you wish to keep your rights for future medical benefits open. All money awarded is paid to you periodically, payable twice per month at the rate of $140.00 up to $270.00 per week (depending on when the injury occurred, how much you earned when you worked, and the level of permanent disability and subject to legislative change) until the full amount awarded is paid. Future medical benefits are available for the industrial injury as long as needed.

The second method of resolving your case is by way of a "Compromise and Release" (C&R). This is a full and complete settlement of all issues: including future medical care. The money is paid to you in a lump sum but you give up any rights to any future medical benefits related to your industrial injury. This amount is higher than the first option because you are essentially selling out your future medical care.