One misconception is that you are going to get benefits similar to those you would get in a personal injury lawsuit, such as missed wages, loss of earning capacity, and compensation for pain and suffering. You do not receive these benefits in workers’ compensation claims. Remember, the purpose of Workers’ Compensation is not to “take care of you” for the rest of your life, but rather to get you “patched up” and back into the work force as soon as is safe to do so. The benefits you do receive are immediate medical treatment paid for by the insurance carrier (not immediately paid in personal injury), immediate payment to you for your time off work (not immediately paid in personal injury), and retraining into another line of work if necessary (not provided at all in personal injury.)
First you must report the injury or illness to your employer or supervisor immediately and complete a simple one-page claim form if more than first aid is required. The claim form will ask what, where, when and how the injury occurred. Your supervisor or employer will see that the claim is turned over to their workers’ compensation insurance carrier and will assist you in getting medical help right away. Prompt reporting is the key. You may not be able to get benefits if you do not file a claim prior to termination with the employer and within one year of the date of injury, the date you knew the injury was work related, or the date benefits were last provided. Insure your rights to benefits by reporting every injury, no matter how small. Even a cut finger can lead to disability if an infection develops.
With each insurance company it varies. Generally, on an accepted claim it takes approximately two weeks to begin seeing payment of benefits.
In an accepted claim, you are entitled to mileage reimbursement for trips to your treating physicians and pharmacies, as well as out-of-pocket expenses for reasonable and necessary medical costs. The defendants have 60 days to make payment from the date they receive your request.
Depending on the facts of your injury, and other issues, the insurance company may not accept your claim right away. However, by law, they must either accept the claim or formally deny it within 90 days from the date you report the injury. You should keep detailed records of the person you reported the injury to and the date. Again, the 90 days expires from the date you report the injury to your employer, not the date the employer reports it to the insurance carrier.
Not necessarily. Many insurance carriers deny claims for various reasons. If your claim is denied, you should immediately speak with an attorney specializing in workers’ compensation or contact the Information and Assistance Officer at the Workers’ Compensation Appeals Board in Sacramento at (916) 263-2741 to determine your rights under Workers’ Compensation Law.
Have you suffered a serious work injury? Contact our work compensation attorneys for FREE consultation about your California workers compensation claim benefits. We’ve been helping injured workers since 1987 and are certified by the State Bar of California.
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I liked the way Mr. Mehlhop handled my case, he was very professional at all times. I feel like he did the best he could considering my wages.