California Workers' Compensation
Workers' compensation coverage is provided by California employers who are injured while performing their normal job function or who are disabled due to an occupational illness or disease. According to California workers' compensation laws and the Division of Workers' Compensation (DWC) who monitors the administration of California workers' compensation claims, and provides administrative and judicial services to assist California employees, employers are required to have workers' compensation insurance if they have even one employee (some exceptions may exist).
The goal of workers' compensation or workman's compensation is to provide immediate relief to workers who are injured in a work-related accident without the employees having to file a personal injury claim and forcing their employer to pay lost wage compensation or for their medical expenses. Employees are limited, under California workers compensation law, in the amount of compensation they can recover from their employer but the trade-off is the employer must pay for necessary and reasonable medical care and in some cases for lost wages without the employee proving the employer was negligent.
California employers who fail to carry workers' compensation coverage may be charged with a criminal offense. According to Section 3700.5 of the California Code "it is a misdemeanor punishable by either a fine of up to $10,000 or imprisonment in the county jail for up to one year, or both". The state can also issue penalties up to $100,000 against illegally uninsured employers.
Work Injuries Covered
Under California Workers' Compensation
In most cases, workers' compensation will only cover work injuries which arise "out of and in the course of employment". If you are injured while performing an activity directly related to your job, you should be eligible for worker's compensation. California employees who are on are injured on a business trip must be engaged in activities required for their job. Workers also may not be covered if they are voluntarily participating in an employee sponsored recreational event, if their injuries are self-inflicted, if they were engaged in horseplay with a co-worker or if they were intoxicated and injured on the job.
Common illnesses and work injuries that are generally covered
if they occur while engaged in normal business activities or functions can include:
- Back injuries
- Amputations of legs, arms, fingers or toes
- Cancer from a certain chemical or toxin
- Heart attack
- Carpel Tunnel Syndrome
- Post traumatic stress disorder
California Worker's Compensation Benefits
There is a three calendar day waiting period before injured employees will receive wage benefits. The three days do not have to be consecutive. If the employee is hospitalized, the injury resulted from a criminal act of violence or if the work injury extends more than 14 calendar days and is unable to return to work the waiting period is waived. The waiting period may also be waived for California employees who meet certain requirements as stated under the California Labor Code Section 4800 and 4800.5.
California workers injured on the job may be entitled to lost wage compensation and paid medical expenses.
- MEDICAL BENEFITS
California workers' compensation laws entitled injured employees to payment or compensation for all necessary and reasonable medical care. Common paid medical benefits can include costs for visiting the hospital, surgeries, medications, dental treatment, and medical supplies. Pain and suffering is not compensated by the employer. California workers' compensation laws allow the employer to make the initial selection for the employee's doctor. The employee will, after a specified time (generally 30 days), be able to choose their own physician unless the employer or the insurance company has previously established a medical provider network. If the California employer has a medical provider network the employee must see a physician from a specified selection of physicians for the duration of the workers' compensation claim.
- TEMPORARY DISABILITY
Temporary disability benefits may also be paid to California workers who are injured on the job. Temporary disability is generally calculated as 2/3 of the employee's gross wages at the time of their work injury. There are maximums and minimum amounts that are paid as outlined under California workers' compensation law. Workers who are working two jobs at the time of injury may also be compensated for the lost income from the second job.
Temporary disability is paid when the treating physician decides that the employee is unable to work more than 3 days or they have been required to stay in the hospital overnight. Temporary disability will end when the doctor determines the employee has reached their maximum health (given their injury) or they are deemed able to return to work.
- PERMANENT DISABILITY
Many work-related injuries will result in permanent disabilities or the inability to work at all. To determine permanent disability compensation the treating physician will determine the degree of the employee's impairment. The impairment is rated according to a pre-determined schedule and the functional loss (as it applies to work related tasks). The workers' compensation claims administrator will assign a permanent disability rating by reviewing the physician's report. The assigned rating may be challenged and a review may be requested from another state disability rater, a workers' compensation judge, or the director of The State Division of Worker's Compensation. Workers compensation permanent disability payments are calculated using this rating, and the employee's wages prior to the injury to determine the total amount of permanent disability compensation for the worker's disability.
- VOCATIONAL REHABILITATION
Injured California workers who suffer an injury at work may also be eligible to receive vocational rehabilitation training. This service is provided through the Division of Workers' Compensation, Vocational Rehabilitation Unit and local community colleges. Injured employees who are injured for 90 days may be eligible for these services. These services are optional.
- DEATH BENEFITS
If a California worker dies from their work-related injury their dependents may be entitled to compensation through death benefits. Death benefits may include lost wages compensation and paid burial expenses up to a maximum outlined in California state law.
Do I Need a California Worker's Compensation Attorney?
Unfortunately, workers in California are injured on the job everyday. Some claims are handled smoothly and easily while others may not. If you have been severed injured or have suffered permanent disability and are unable to work again, it may be a good idea to discuss your California workers compensation case with a workers compensation attorney. Workers compensation lawyers have the experience to fight the insurance companies and ensure that they do not limit or deny workers' compensation benefits to injured employees.
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