Workers’ compensation is a safety net for employees injured on the job and protects employers from being sued in Superior Court. By paying an annual insurance premium, employers are transferring the financial risk of paying for benefits to the insurance company. In the case of an employee illness or injury, employees will file a claim with the insurance company to receive benefits such as medical care and lost wages.
Who qualifies for workers’ compensation benefits?
Employees who suffered an injury while on the job or became ill due to work conditions could qualify for workers’ compensation benefits. Employees may receive benefits regardless of who was at fault. In exchange for these benefits, employees do not have the right to file a lawsuit against their employer for damages, with a few exceptions. Instead, workers’ compensation benefits are handled by judges at the Workers’ Compensation Appeals Board (WCAB).
The eligibility requirements for workers’ compensation benefits are:
● The worker is a W-2 employee.
● The employer must have arranged for workers’ compensation benefits if an employee is injured.
● The injury or illness must be work-related.
● The employee reports the injury or illness and files a workers’ comp claim before certain deadlines.
Who is required to have workers’ compensation insurance?
All employers in California with at least one employee are required to have workers’ comp protection for their employees. Private companies may buy insurance from an insurance company or a State agency.
How do I file a workers’ comp claim in California?
Each employer must provide employees with information about filing a workers’ compensation claim with their workers’ compensation administrator. It’s critical to follow the reporting deadlines to protect your potential claims.
Employees should also fill out the employee section of the WORKERS’ COMPENSATION CLAIM FORM (DWC 1) and provide a copy to their employer. Employers are required by law to fill out their portion of the form and provide copies to their insurer and employee within one business day of receiving the form from the employee. Our firm can assist employees in this process.
Who needs a work injury lawyer in Orange County?
Many claims can be processed by the employee, while others may be complex and may require the assistance of a workers’ compensation attorney. Employees may not need a work injury attorney if:
● Their injury is minor, such as a sprained ankle or a cut requiring stitches.
● The employee missed little to no work due to injury or illness, and
● There is a full and complete recovery.
If there are unique circumstances regarding the injury or illness, employees may want to consult with a workers’ compensation attorney. These instances may include the following:
● The employer denies the claim or fails to pay the benefits on time.
● The employer refuses to provide reasonable treatment.
● The injury or illness prevents the employee from returning to their previous job, limits their working capabilities, or keeps them from working completely.
● The employee has questions about how workers’ compensation benefits are coordinated with other benefits, such as State Disability Insurance (SDI), Long or Short Term Disability, Social Security, Medicare, and other benefits.
● The employer retaliates against the employee for filing a workers’ comp claim.
● The employee’s injury or illness occurred because of a third party’s actions or employer gross negligence.
The Next Step
Choosing a competent workers’ comp lawyer is the best way to make sure you receive all of the benefits you are entitled to. To discuss your claim with award-winning attorney Thomas F. Martin, call us today at 714-547-5025, or reach out to us online to schedule a free and confidential consultation.
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