Let us take a look at the law regarding worker’s compensation in Oakland and other parts of California.
If you have suffered an injury at your workplace it can change your lives and that of your loved ones. Dealing with an injury, the high cost of treatment, and the trauma that comes along is never easy. Serious injuries or illness which requires life-long medication and long rehabilitation can hit your future plans with a sledgehammer. Thankfully the law in California entitles you to benefits under California’s Workers Compensation Act. As per the law, any employee who suffers work-related illness or injury is entitled to compensation from the employer. This compensation includes the cost of medical treatment as well as partial wage. This helps as a replacement for the period you miss work during your recovery process.
The Process of Filing for Compensation :
The law for worker’s compensation in Oakland clearly defines the three-stage process for filing a compensation claim. Here we take a look at these three stages involved in the process –
Reporting the Injury
Before we get into the details of reporting an injury. You need to bear in mind that the earlier you report more are your chances of getting due compensation. The clock keeps ticking and you need to report an injury within a strict deadline. The day you suffer an injury is a day you need to report that to your employer. However, there are some waivers as far as reporting work-related injuries and illnesses is concerned. In case of traumatic injuries. This is cause by working in a hazardous environment such as exposure to chemicals.
You can report the injury in the following events –
You are missing your first day to work or seeing a doctor with respect to an illness or injury. That can be linked to your workplace the doctor explains to you about the injury or illness. You know that the illness or injury cause by your professional role.
Filing the Claim with Your Employer
As stated above the moment. If you suffer from an injury or illness you need to bring it to the notice of your employer. In the case of non-emergency situations, you should get the treatment from a network health center as per your insurer. In case of an emergency, you entitle to go anywhere for medical care. It is important to note that you will need to file a formal compensation claim. Within a period of 30 days with your employer. While there are exceptional cases where you can file for compensation after the 30-day period. You shouldn’t delay taking up the issue with your employer.
Under the usual process, your employer would give you a Workers’ Compensation Claim Form (Form DWC-1) within a day of filing your formal compensation claim. This form contains details of your rights and eligibility for benefits. Carefully fill up the employee portion of the form and provide as many details about your injury or illness as required. Submit this to your employer who would further fill up their portion and submit it to the insurer.
In usual cases, the insurance company of your employer authorizes payment with respect to medical treatment of up to $10,000 while the claim is being investigated and settled. If the insurer doesn’t deny the claim within a period of 90 days it shall be considered approved. For your absence from work due to the concerned illness or injury, the insurance company needs to pay you disability benefits within 14 days of receipt of the compensation claims at their end. If they default on this payment you are entitle to an additional 10% for the delay in providing you these benefits.
Filing Application for Adjudication of Claim
While the law might entitle you to compensation and the insurer and the employee often agree to the compensation amount and settlement in cases of minor illness or injury disagreements are also common especially when the injury is of serious nature. In such an event you need to file an application for adjustment of claim using the Application for Adjudication of Claim (WCAB-1). This process complicates for you and you need a specialized workers’ compensation attorney in Oakland CA and other parts of California by your side. Hire one who comes with a proven track record. You can file this application within a span of one year of –your date of injury or when you became aware of workplace-related illness the last date you were provided medical benefits by your employer the last date when the temporary disability benefits were provided to you.
When you retain an attorney specializing in worker’s compensation they would clearly explain to you the future course of action and help you in filing your claim and getting maximum eligible compensation.
Summary :
In this write-up, we take a look at the process of claiming benefits under the California Workers’ Compensation Law.
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