When you’ve suffered a workplace injury, you may not know what to do next. Do you try to work through the pain? Are you worried that your employer will blame you? Are you concerned about the cost of medical treatment?
The workers’ compensation system should help alleviate your concerns. It’s a no-fault system, which means you can receive benefits no matter who is to blame for the accident. Your employer cannot legally fire you for making a workers’ comp claim. Most importantly, your medical treatments should be covered through workers’ compensation.
It’s Important to Speak Up Quickly
The fastest way to get medical treatment for a workplace injury is to make a claim with your employer as soon as possible. Under the California Labor Code, you generally have 30 days to notify your employer and up to one year to file your claim with the California Division of Workers’ Compensation (DWC).
Once you file, your employer forwards the claim to the insurance company. An administrator at the insurance company will decide whether to accept or deny your claim.
However, you don’t have to sit around waiting for a decision. By law, the claims administrator is required to authorize up to $10,000 in medical treatment within one working day after you’ve filed your claim with your employer. Workers’ comp should still cover this initial treatment, even if your claim is ultimately denied.
What Types of Treatment Can I Receive?
In California, the treatment of work-related injuries is governed by the Medical Treatment Utilization Schedule (MTUS). The MTUS contains treatment guidelines and rules for deciding which care is medically necessary.
Covered treatments typically include:
- Doctor visits and hospital care
- Prescription medications
- Diagnostic testing (X-rays, MRIs, lab work)
- Physical therapy and rehabilitation
- Surgery, when required
- Travel costs for medical appointments
Sometimes, a course of treatment may not be covered by the MTUS. Other times, your doctor may disagree with the MTUS recommendations. In these cases, your treatment may undergo Utilization Review (UR) and possibly an Independent Medical Review (IMR) if a dispute arises. With the support of a skilled attorney, you may also secure an exception for necessary medical care.
What Benefits Are Available Under California Workers’ Compensation?
Workers’ compensation is more than just medical treatment. If your claim is approved, you may also be entitled to:
- Temporary Disability Benefits: Payments that partially replace lost wages while you recover.
- Permanent Disability Benefits: Compensation if your injury results in lasting impairment.
- Supplemental Job Displacement Benefits: Vouchers to help pay for retraining or skill enhancement if you cannot return to your old job.
- Death Benefits: Financial support provided to surviving dependents in the event of a fatal workplace accident.
Protection Against Retaliation
Many injured workers fear retaliation. Under California law, it is illegal for your employer to fire, harass, or retaliate against you for filing a workers’ compensation claim. If this happens, you may have grounds for a separate legal action against your employer.
Disputes and Appeals
Not every claim is straightforward. If your claim is denied, you have the right to appeal the decision before the Workers’ Compensation Appeals Board (WCAB). The process can be complex, involving deadlines, hearings, and medical evidence. Having legal representation significantly improves your chances of success.
Why Legal Guidance Matters
While the workers’ compensation system is designed to protect employees, the reality is that insurance companies often delay, limit, or deny valid claims. Having a knowledgeable attorney ensures:
- Your claim is filed on time and with complete documentation.
- You receive the full range of benefits you’re entitled to.
- You have strong advocacy if your case goes to appeal.
At Hussain & Gutierrez, our attorneys focus on helping injured workers in California navigate the workers’ compensation system with confidence.
Frequently Asked Questions (FAQs)
How long do I have to file a workers’ comp claim in California?
You must notify your employer within 30 days of the injury. You generally have one year from the date of injury to file your claim with the DWC.
What happens if my workers’ comp claim is denied?
You can appeal the denial before the WCAB. An attorney can guide you through the process, including medical evidence and hearings.
Can I choose my own doctor for treatment?
Initially, you may be required to see a physician within your employer’s Medical Provider Network (MPN). After a certain period, you may have the right to switch doctors.
How much will I receive in wage replacement?
Temporary disability benefits are usually two-thirds of your average weekly wages, subject to state maximum and minimum limits.
Can my employer fire me for filing a claim?
No. Retaliation for filing a workers’ comp claim is strictly prohibited by California law.
What if my injury develops over time, like carpal tunnel syndrome?
Cumulative trauma injuries are also covered under workers’ comp. You should report the injury as soon as you become aware of its connection to your job.
A workplace injury can put your health, job security, and finances at risk. Don’t leave your future in the hands of insurance companies. The sooner you seek legal guidance, the stronger your case will be.
At Hussain & Gutierrez, we provide dedicated support to injured workers across California. Contact us today to schedule a consultation and learn how we can protect your rights.
