California has an odd mix of generous and frustrating workers’ compensation laws. In terms of who is covered, it probably has the most generous laws of any state in the country.
However, because these laws limit which doctors an injured worker can get treatment from, claimants often run into complications when trying to obtain benefits. Due to these and other restrictions, it is a good idea for claimants to consult with a Fresno workers’ compensation lawyer before filing a claim.
Who Is Protected by Workers’ Compensation Laws in Fresno, CA?
According to California law, nearly everyone is protected by workers’ compensation laws in California. If a California business has any employees, they are legally required to either purchase a workers’ compensation policy for all employees or, if they are financially secure enough, to self-insure.
The only workers in California not covered by workers’ compensation laws are independent contractors or sole practitioners with no other employees.
Workers’ Rights Under Fresno, CA, Workers’ Comp Laws
Injured workers have the right to receive compensation for all medical care and a portion of lost wages after suffering an injury or illness at the workplace. Additionally, workers’ loved ones have the right to compensation when a worker dies at work. To take advantage of these rights, an injured worker must follow all steps of the workers’ compensation process, including promptly informing their employer of the injury and filing a workers’ compensation claim.
When you are injured, you must be seen by a physician chosen by your employer unless you predesignated your own personal physician in writing before the date of the injury.
Filing Process for Workers’ Compensation in Fresno, CA
Filing a workers’ compensation claim in California is a relatively complicated process. Injured workers will likely get the best results if they contact a Fresno workers’ compensation lawyer before contacting their employer or filing a claim. Typically, this process will involve the following steps.
- Emergency room visit. The first step in any workers’ compensation claim is immediately going to the nearest emergency room if injured seriously enough to need emergency treatment.
- File a claim. The injured employee must fill out a DWC1 (Workers’ Compensation Claim Form) and deliver it to their employer as soon as possible. This form is available from the California Department of Industrial Relations or an employer.
- Evaluation of claim. The claims administrator decides whether to accept or deny your claim.
- Get assigned a doctor. If you have not designated your own physician, the insurance company will assign a doctor or provide a list of doctors from which the employee can choose. This becomes the primary physician who evaluates the injury and determines the justified treatment.
- Receive treatment. The injured worker must visit doctors and receive treatment as instructed. Refusing treatment can jeopardize their benefits.
- Contest decisions as needed. If the worker doesn’t agree with some portion of their treatment or the claim is denied, they may appeal the decisions of their doctor or the insurance company. Depending on the circumstances, this may require filing a lawsuit.
Even if a worker doesn’t hire a Fresno workers’ compensation lawyer before filing for benefits, they should immediately consult with one if they are considering an appeal.
Workers’ Recovery for Workplace Injuries Beyond Workers’ Comp in Fresno, CA
Just because workers’ compensation insurance is mandated by law, that doesn’t mean that every employer purchases it. If a worker discovers their employer hasn’t properly insured them, California offers a way to get compensation still.
Injured workers should file a workers’ compensation claim in the same way that they would if their employer had workers’ compensation insurance. They should also file a lawsuit against their employer. If a California court determines that the worker is eligible to receive benefits, they will be covered by the Uninsured Employers Benefits Trust Fund. This fund awards compensation even when an employer cannot compensate an employee properly.