What Happens After I File a Workers Comp Claim in California?

Maison Law guides injury victims through the workers’ compensation claims process in California. Every claim is different, but there’s a general way that the process works once your claim is filed. Trying to figure out what will happen, though, requires experience. Our workers’ compensation lawyers know how things work and will help you through it. Contact us today for a free consultation.

What Happens After I File a Workers Comp Claim?

When you get hurt or sick at work, you have the ability to file a workers’ compensation claim. It’s actually fairly easy to do: you simply tell your employer about the accident, get medical help, and then go to HR and ask for the form (DWC-1). Once you fill it out and turn it in, your claim will officially be filed.

But this also means you have to go through the claims process. While every claim is different, there are some general steps that happen in every claim. Usually this means the following things happen:

• Investigation – The insurance company will investigate your claim, which may include reviewing records and speaking with witnesses.
• Medical evaluation – You may need a medical evaluation by a doctor (a Qualified Medical Evaluator) chosen by the insurance company, but you can also consult your own doctor.
• Claim decision – The insurance company will decide if your claim is approved and specify the benefits you will receive.
• Resolving disputes – Disputes over your claim might require mediation, negotiation, or a formal hearing to resolve.
• Return to work – If possible, your employer may offer a job that fits your medical restrictions, or you could get help with retraining and finding new work.

What’s good about workers’ comp is that–unlike a civil claim–you don’t have to show fault. You can just file your claim and start receiving benefits. But the benefits you can get depend on the circumstances.

What Benefits Can You Get in a Workers’ Compensation Claim?

You obviously never want to be in a position where you have to file for workers’ comp. That said, given that California has a variety of different jobs and industries, accidents and injuries do happen. This means medical bills and other losses you’re going to have to deal with, and that’s the main reason why you’d need to take workers’ comp. Still though, it’s important to look at the benefits you can get when you file your claim:

• Medical expenses – This provides benefits for all doctor visits, treatments, medications, and therapies related to your condition.
• Temporary disability – If your injury or illness prevents you from working temporarily, you can receive a portion of your wages to help during your recovery.
• Permanent disability – If the condition results in long-term or permanent damage, you may be able to get benefits based on how much it affects your ability to work.
• Job retraining – If you’re unable to return to your previous job due to your condition, workers’ comp may help cover the cost of training for a new job.

Because you don’t have to prove that your employer was at fault for your injury or illness, workers’ comp is a relatively straightforward option for financial and medical support. However, in some cases, these benefits might not fully cover your needs–especially if the condition is severe or long-lasting.

If the benefits fall short, you may have the option to file a lawsuit against responsible parties, such as your employer or a third party, like equipment manufacturers or product suppliers. A lawsuit can provide additional financial support (known as damages) for things like lost income, medical expenses, and the emotional toll of your injury or illness.

Should You Get a Lawyer For a Workers’ Comp Claim in California?

Understanding your rights and options can make all the difference when you need to file a workers’ comp claim. If you’re going through a work-related injury or illness, things are hard enough without also trying to focus on the claims process and all that comes with it. So, while you’re not required to get a lawyer to file a workers’ comp claim, having experience on your side can make things much easier. Here’s what our team at Maison Law can do for you:

• Explaining your rights and options – We’ll guide you through the process and ensure you understand all the claims you can file.
• Investigating your accident or conditions – We’ll help gather evidence to support your claim and make sure your case for benefits is as strong as possible.
• Negotiating with the insurance company – We’ll work with your employer’s workers’ compensation insurance company to secure the best possible benefits for you.
• Taking additional steps – If needed, we can help you pursue further legal action, such as filing a lawsuit, to make sure you get the financial support you’re owed.

No one expects to get injured or sick at work, but it happens far too often. When it does, you shouldn’t have to face the process alone. Let us handle the responsibilities of the claims process so you can focus on your recovery and getting back to your life. Contact us today for a free consultation.