If you’ve sustained a workplace injury in California, then you need to file a claim form (DWC-1) with your employer as soon as possible. If your employer refuses to provide you with a claim form, you may want to consider contacting a lawyer.
Turn in a Claim Form
The first step is to inform your employer or supervisor of the injury or illness. Whether they dispute the claim or not, the employer should provide you with a claim form within one business day.
The claim form will ask for the following information:
● Your name and address.
● Date and time of injury (or the period of time you were exposed to harm)
● Address and description of the accident location
● Injury and the affected body parts
● Social security number
● Signature and date of form completion
Failing to return the form to your employer could result in your claim being barred. If you have questions or concerns about how to fill out the form, a work injury attorney in Orange County (or the County you live or work in) can assist you.
The Employers Responsibilities
The employer is then required to complete the “employer” section on the form, which will require the following information:
● Employer name
● Business address
● Date employer learned of the injury or illness
● Date the claim form was provided to the employee
● Date the employer received the completed claim form from the employee
● Name and address of the workers’ compensation insurance company
● Insurance policy number
● Employer signature
The employer must forward the completed claim form to their workers’ compensation insurance company or claims administrator and should also provide you with a copy. Within one day of receiving the completed claim form from you, the employer should authorize up to $10,000 in medical treatment, at least until the claim is denied.
If the case is accepted, medical treatment should continue. If you’re able to continue working with some limitations, the employer should provide modified duty consistent with your treating doctor’s recommendations, if possible.
The Claims Administrators Responsibilities
Once the insurance carrier has received the claim form, it should issue a response within 14 days, letting you know the status of your claim. You may also contact the claims administrator to find out the status of your claim if you don’t hear back within two weeks.
The Claims Administrator is required to provide you with WRITTEN notices covering various rights, such as:
1. The procedure for beginning the process of collecting workers’ compensation benefits
2. Information about types of workers’ compensation benefits
3. Steps taken once the claim form is filed
4. Where to obtain medical care for the injury or illness
5. The responsibilities of the primary care physician
6. Employee legal rights to select and change their primary care physician
7. How to obtain medical care while the claim is pending
8. Protections against discrimination in the workers’ compensation claims process
9. Employee rights to disagree with decisions affecting the claim
The Next Step
If the employer or claims administrator is not cooperating with providing you medical treatment for ALL of your injuries and/or refusing to provide you wage replacement benefits that may be due, consider having a competent work injury lawyer in Orange County represent your interests.
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.