Worker’s compensation in California covers workplace injuries and disabilities that occur during job performance, and the law mandates that all employers carry a worker’s compensation insurance policy, no matter how many employees. Besides being complex, worker’s compensation laws and policies are subject to amendment without notice. Those are two reasons that a workers compensation attorney should be contacted before you begin the process of filing a claim.
It’s considered to be a no fault insurance with benefits that include medical care, temporary and permanent disability, supplemental job displacement and death benefits when necessary. The employer should provide the injured employee with a claim form within 24 hours from their notice of injury. A workers compensation lawyer can help with the general claims, denial of medical treatments, or appeal decisions.
California was one of the first states to establish a worker’s compensation program and adopted the required system that exists today. The program was established to compensate employees for job related injuries, and illness providing a limited liability for the employer. It is illegal for an employer to fire or reprimand an employee for filing a worker’s compensation claim.
A third party or claims administrator must authorize medical treatment within 24 hours of receiving the claim. The medical treatment is limited to $10,000 for work related injuries and continues according to state limitations for the type of treatments prescribed. California allows for 24 visits to chiropractors, physical therapies and occupational therapies. Additional visits need to receive approval from the claims administrator, if treatments are denied but medically required, then a workers compensation attorneys should be contacted.
Worker’s compensation retains a network of health care providers to treat work related injuries. California’s workers compensation program requires that an injured employee see an approved provider within the network. Some employer plans allow employees to select their own personal health care provider for job related injuries prior to the injury or illness.
California compensation benefits provide for lost wages during medical treatments and recovery from job related injuries and illness. California laws have two forms of temporary benefits; full disability for workers who cannot work during recovery, qualify for two-thirds of their gross wages during recovery. The second is a partial disability for employees able to do some work during recovery. Both categories have limits set by the state.
In the event a physician determines that the employee is permanently disabled due to the work related injury or illness, the amounts of compensation disability is set by state law. The state will rate the injury to the extent of the disability and calculates a percentage of the employee’s wages before the work related injury or illness occurred. The claims administrator will authorize permanent disability payments to begin two weeks from the end of temporary disabilities.
If a worker dies from a work related injury or illness, death benefits are paid to the surviving spouse and children. In this case, workers compensation lawyers should be contacted to ensure that benefits are filed properly.
Work Return and Retraining
The healthcare physician treating the injured employee will determine if there are work limits for the employee returning to work. If there are no restrictions the employee can resume the normal work task and pay rate prior to the injury. If there are temporary restrictions, the employer must comply and assign work to the employee within the medical restrictions.
Permanent restrictions prevent retraining of the employee under the California state law, and prevent the employee from returning to the pre-injury job position. Under the California state law there are options for the state’s supplemental job displacement benefit program, which the employee must qualify to receive. The program provides assistance for retraining or skills improvement.