A California employee who is injured on the job should take these steps to protect the right to receive workers’ compensation
Employees who are injured while working can obtain medical care and other benefits through the workers’ compensation system. Following these simple steps will help you preserve your right to receive workers’ comp benefits if you are injured in a workplace accident.
If You Need Emergency Care, Call 911
Nothing in California’s workers’ compensation system requires an injured worker to risk his or her life in order to obtain benefits. If you sustained a life-threatening injury that requires immediate care, don’t worry about filling out forms. Call 911 and ask for an ambulance or have a co-worker make the call for you. If you injured your head or neck, wait for paramedics. Don’t let anyone move you who has not been trained to assess head or neck injuries.
If you need emergency care but the injury is not life-threating, ask a supervisor to arrange your emergency care at a facility chosen by the employer. If no supervisor is available who can make a prompt decision about emergency care, however, you should go to the nearest Emergency Room. Unless someone is available to drive you there, call an ambulance.
Once you arrive at the ER, tell the doctor how the injury occurred. Make sure the doctor understands you were injured at work. The hospital must then bill your employer, not you.
Report the Injury
If you do not require emergency care, you should report the injury to your employer immediately. If you obtained emergency care, you should report the injury as soon as you can.
After you tell your employer about the injury, your employer is required to give you a “Workers’ Compensation Claim Form.” Your employer must give or mail the form to you within one day after you notify the employer that you were injured on the job.
Fill out the employee’s part of the claim form and return it to your employer. Describe your injury in detail, listing every part of your body that was bruised or cut, or in which you feel any pain, no matter how slight. Injuries that are not very painful when they first occur sometimes become more painful over time. Listing them on the form helps you prove that the injury was work-related.
You should give written notice of the injury to your employer within 30 days, but it is best to complete the form as soon as you can. Providing the form triggers the employer’s obligation to provide workers’ compensation benefits. If you have to mail the form to your employer, send it certified mail and ask for a return receipt.
Within one day after the employer receives the claim form, the employer must complete the rest of the form and must provide a copy to you. Keep the copy because you may need it later. If you do not receive it, ask your employer to give it to you. If you still do not receive it, talk to a Santa Rosa workers’ compensation lawyer.
Obtain Necessary Healthcare
When you report an injury to your employer, you likely will be told where you are required to go to obtain medical care. That information should also be on a poster displayed somewhere at your work location. Your employer should have given you the name and location of its workers’ compensation medical provider when you were hired.
Generally you must obtain treatment for a work injury from the medical provider designated by your employer. If you do so, the cost of the medical care will be paid by your employer or its workers’ compensation insurance company. You may end up paying medical bills out of your own pocket if you do not use the medical provider designated by your employer.
Make sure to tell the doctor that you were injured at work. The doctor will then send any medical bills to your employer or to its workers’ compensation insurance company for payment. You should never be billed for medical care you receive from your employers designated doctor.
Document the Accident
In some cases, an insurance company will deny a claim alleging that the employee was not injured at work. It is therefore helpful to have proof that the injury occurred while you were working.
Tell your supervisor about the injury as soon as it occurs. If co-workers witnessed the accident, make a note to yourself of their names. Don’t be afraid to complain about your pain. If you hurt your back lifting a box, tell co-workers and your supervisor that your back hurts. Don’t try to tough it out for fear of looking weak. Don’t do anything that will negatively affect your ability to collect the workers’ compensation benefits to which you are entitled.
If Your Claim is Accepted
After your employer completes the claim form, it will be sent to a workers’ compensation insurance company (or to the employer’s claims department if the employer is self-insured). A claims administrator will decide whether to accept or deny the claim.
If the claim is accepted, the medical treatment you continue to receive for your injury is generally paid for by your employer or its insurer. If you miss more than three days of work or stay in a hospital overnight, you will also be eligible for temporary disability benefits. Your employer is required to furnish the claims administrator with evidence of your wages, but you should provide any additional wage information you have related to earning at any additional jobs to assure that you receive the full disability benefit to which you are entitled.
Follow your doctor’s advice and don’t do anything that might make your injury worse. If your treating physician eventually determines that you have a permanent disability that was caused, or aggravated, by your workplace injury you will be entitled to permanent disability benefits. You should talk to a Santa Rosa workers’ compensation attorney about negotiating a favorable settlement of those benefits.
If Your Claim Is Denied
Claims may be denied if the claims administrator believes the injury is not work related for some reason. You have a right to challenge that decision, but you must do so promptly. Obtaining immediate legal advice is your best protection against the unjust denial of workers’ compensation benefits.
Get Legal Advice
Some workers’ compensation claims are so straightforward that there is no need to ask an attorney for help. When a claim is denied, when an injury is permanent, or when an injured worker disagrees with a claims administrator, it is time to get legal advice. To learn how a Santa Rosa workers’ compensation lawyer can help you with your workplace injury claim, call Kneisler & Schondel at (707) 542-5132. You can also ask us a question by submitting our online contact form.