Under California Labor Code 3600, an employee injured on the job can claim benefits by filing a worker’s compensation claim.
California Labor Code 3600 protects the rights of an employee and their benefits if they are involved in a work-related incident. Additionally, every employee has the right to file a workers’ compensation claim if they suffer an injury or illness because of their job. Filing a workers’ compensation claim is easier than it may seem, and covers employees’ financial needs and medical expenses.
What to Do If Injured at Work
An employee should always report the injury or illness that occurred at work so they can rightly receive medical and financial aid. Here is everything an employee should know about reporting a workplace injury and what to do after.
1. Report the injury promptly.
After an employee is injured at their place of employment, it is crucial that they report the incident to their employer as soon as possible. Failing to report the injury or illness swiftly will delay the process of receiving benefits. Additionally, if a worker does not file their workers’ compensation claims within 30 days, they could lose their right to receive any workers’ compensation benefits.
2. Seek emergency treatment
If it is a medical emergency, do not hesitate to go to the emergency room immediately or call 911. It is important that the employee informs the medical staff that this injury is work-related. If the employee is able to do so, they should contact their employer for further guidance.
3. Know your right to medical care.
California workers’ compensation law mandates employers to authorize and fund all medical care that is reasonably required to cure or relieve the effects of a workplace injury. The doctors that are treating the employee are required to follow the medical utilization schedule (MTUS), and only the treatment that meets the requirements specified must be permitted.
Related: California Workers’ Compensation Laws
How to File a Workers’ Compensation Claim
An employee looking to receive benefits for their work-related injury should file a workers’ compensation claim.
To begin, an employee should fill out the employee-designated section of the form here. (The form can also be found on the forms page of the California Department of Industrial Relations.)
Then, an employee should get their employer to complete the designated “employer section”. After the form is complete, an employee should make a copy of it and then submit a copy to their insurance company.
The insurance company is allotted 14 days to mail the employee a status on their claim. If an employee does not receive an update from their insurance company within 14 days, they should contact them regarding the status of their claim.
Related: Workers’ Comp: File & Prove a Claim
What Happens If the Claim is Accepted?
An employee can expect to find out if their workers’ compensation claim is accepted or denied by their employer or their claims administrator within 90 days of filing. If they do not, it is presumed that the injury is going to be covered.
If the claim is accepted, workers’ compensation will provide the employee with five benefits:
- Medical care
- This will be covered financially by the employer as designated by California workers’ compensation law.
- Temporary disability benefits
- This covers any wage payments that are lost because the injury has prevented the employee from doing their job.
- Permanent disability benefits
- These are any additional payments if the employee does not and cannot ever fully recover. More information on permanent disability benefits can be found here.
- Supplemental job displacement benefits
- These are vouchers to aid in paying for retraining or skill enhancement if the employee does not make a full recovery and does not return to work for the employer.
- Death benefits
- These are payments to the spouse, children, or other dependents if the worker dies from a job injury or illness.
Related: How Long Can I Receive Workers’ Compensation Benefits?
What kind of medical care does the Medical Treatment Utilization Schedule (MTUS) allow? How can an employee know if their injury falls within these guidelines?
Any employee who is curious about whether or not their specific situation is permitted medical treatment can read the regulations set by the MTUS in the California Code of Regulations sections 9792.20-9792.27.23. This is the full set of guidelines that determine what is considered reasonable medical care.
Is there a limit on how much treatment an employee can receive?
Every employee is limited to a total of 24 chiropractic visits, 24 physical therapy visits, and 24 occupational therapy visits.
What happens if the claim is denied?
A claim that is denied by the claims administrator will have a letter explaining why they believe the injury is not covered by workers’ compensation. However, every employee has the right to challenge this denial. If an employee does want to object to the denial of their claim, they will have to file a case at their local DWC office (Division of Workers’ Compensation).
Contact Us
If you or a loved one is looking to file a workers’ compensation claim under California Labor Code 3600, contact us. Get your free consultation with one of our Work Injury Attorneys today!