If you suffer an injury at work in California, you must file a workers’ compensation claim to receive the benefits you need for recovery. Knowing the process helps you take the right steps and ensures that you secure the coverage you deserve.
Report your injury to your employer
Immediately report your injury to your employer. You must notify them within 30 days of the injury, and you can do this verbally or in writing. Prompt reporting ensures that your employer takes the necessary actions to start the claims process. If the injury is severe, inform your employer right away.
Seek medical treatment
After reporting the injury, seek medical treatment. Your employer may have a Medical Provider Network (MPN) of doctors to choose from. If not, you can select your own doctor. Keep track of all your medical visits, treatments, and prescriptions since you will need this information for your claim.
Complete the claim form
Next, your employer must provide you with a workers’ compensation claim form (Form DWC-1). This form asks for details about your injury and how it happened. Fill it out completely and submit it to your employer. They will then send it to their workers’ compensation insurance company. Make sure to fill out the form accurately to avoid delays.
Insurance review and decision
After you submit the claim, the insurance company will review it and decide whether to approve or deny your claim. This process may take up to 90 days. If they approve your claim, you will receive benefits like medical treatment and temporary disability payments. If they deny your claim, you can appeal the decision.
Appeal a denied claim
If the insurance company denies your claim, you can appeal their decision. You can request a hearing before a workers’ compensation judge. During the hearing, present your evidence and explain why the claim should get approval.
Filing a workers’ compensation claim doesn’t have to be overwhelming. By staying organized, keeping detailed records, and communicating clearly with your employer and insurance company, you can move through the process with ease.