Workplace injuries are common in California. Whether or not the employer was at fault, the injured employee is entitled to receive workers’ compensation benefits if the employee needs medical care. If you are injured at work, the California workers’ compensation lawyers at Arshakyan Law want you to understand the 7 steps you should take to protect your right to receive full benefits.
1. Notify Your Employer
As far as the legal system is concerned, the first step you should take to preserve your right to collect workers’ compensation benefits is to notify your employer of the injury. As a practical matter, whether that should be your first concern depends on the nature of your injury.
In some cases, your first concern may be to obtain medical attention. If you suffer the kind of injury that requires an ambulance to be called, you might not be in a position to talk to your employer. It is always fine to take care of your emergency health care needs before you report the injury to your employer, as long as you report the injury as soon as you can.
Most work-related injuries happen in the workplace, so notifying your employer is often a question of notifying a nearby supervisor. However, some work-related injuries occur away from the place where the employee usually works. For example, if you are injured in a traffic accident while doing work-related driving, you should call your employer to report the injury as soon as you can.
California law sets a 30-day time limit for reporting an injury. If you wait more than 30 days, your employer might not be required to provide workers’ compensation benefits. Employees do not always lose their benefits if they delay reporting by more than 30 days, but there is no reason to take that chance. The best practice is to report the injury as soon as you are able to contact your employer.
The 30-day time limit begins when the injury occurs. In some cases, however, the occurrence date is not easy to determine. A repetitive stress injury (like carpal tunnel) or an occupational disease caused by exposure to a toxic substance may develop over time. In those cases, the 30-day time period starts running on the date you realize (or should have realized) that the injury or disease is work-related.
2. Get Treatment for Your Injury
If you need emergency care, the paramedics who respond will probably transport you to the Emergency Room of their choice. If your injury does not require emergency care, your employer will tell you where to get treatment.
California employers are required to post a notice to employees at the work site that advises them of the Medical Care Network that the employer uses to treat injured employees. That network or organization will assign a primary care physician. If you can’t find the poster, ask your supervisor, the employee benefits department, or the business owner to tell you where you should seek treatment.
You may be able to have your own physician treat your injury, but only if you predesignated the physician. Employees are generally eligible to predesignate a physician if they have group health insurance that the employer provides. Your physician must agree in advance to treat you if you are injured at work. You must predesignate your physician in writing before you are injured.
3. Notify the Primary Care Physician that the Injury Is Work-Related
Employers must pay an employee’s medical bills for on-the-job injuries. For that reason, it is important to tell the treating physician (and/or the billing department at the clinic or hospital you visit) that your injury is work-related. If you do that, the physician will bill your employer or its workers’ compensation insurance company. You should never receive a bill for medical treatment.
4. Explain All of Your Symptoms to the Doctor
Doctors can’t treat health problems unless they understand your symptoms. Just as importantly, doctors make notes about what you tell them. Those notes need to be complete, because they will be important evidence in your workers’ compensation claim.
If you feel serious pain in your back after falling and only a small twinge in your elbow, don’t decide that only the back pain is sufficiently important to mention to the doctor. It might turn out that the elbow pain will become a lasting problem. If you don’t mention it to the doctor, however, the insurance company might argue that impairment to your elbow wasn’t caused by your work injury.
5. Submit a Claim Form
Within one day after you report your injury, your employer must give you a claim form. You will need to fill out part of the form. After you complete it, return it to your employer immediately. Your employer will fill out its part of the firm and will submit it to its workers’ compensation insurance company. At that point, the insurer will assign a workers’ compensation claims administrator who will manage your claim.
It’s important to submit the claim form right away to assure that you receive timely benefits. For example, if you spend the night in a hospital or miss more than three days of work, you will be entitled to temporary disability benefits. Those benefits are paid every two weeks. You should submit a claim form promptly to assure that the benefits are paid on time.
If your employer refuses to give you a claim form, contact a California workers’ compensation lawyer at Arshakyan Law for assistance.
6. Follow Your Doctor’s Advice
Some employers pressure their employees to return to work before their doctor tells them that they are ready to work. Some employers want an employee to perform job duties that are contrary to a doctor’s restrictions. For example, if a doctor has cleared a return to work with a 10-pound lifting restriction, don’t agree to lift 20 pound boxes just because your doctor wants you to resume your former job duties.
You can take care of your health and protect your rights by following your doctor’s orders. If an employer threatens you with termination or discipline because you won’t disobey a restriction, or if your employer threatens to fire you unless you return to work without your doctor’s clearance, get legal advice from an Arshakyan Law workers’ compensation lawyer.
7. Get Legal Advice
In addition to payment of medical expenses and temporary disability benefits, you may be entitled to permanent disability benefits. Those benefits are paid whether or not you return to work, if your injury does not fully heal and if your doctor decides that you will always be impaired by the injury. Whether the impairment is slight or serious, you should receive permanent disability benefits.
Calculating a permanent disability benefit is complicated. In addition, insurance companies are usually willing to pay a higher lump sum benefit in exchange for giving up the right to collect future medical costs. Whether that is a good deal depends on the circumstances.