When an employee is injured on the job, there is a process in place to help the worker secure compensation for his or her injuries, damages and losses. Typically, when a worker suffers a job-related injury, filing a workers' compensation claim would be the first step.
In California, employers with 15 employees or more are required to have workers' compensation insurance precisely to ensure that workers have the resources to seek medical care and treatment and that they are reimbursed for at least a portion of wages lost as they recover from their injuries.
How to Claim Work Injury Compensation
If you've been injured on the job, it's crucial to act quickly to protect your rights. Here's a step-by-step guide on how to claim work injury compensation:
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Report the Injury Immediately
Notify your employer as soon as possible. In California, for example, you must report your injury within 30 days. Failure to do so could jeopardize your claim. -
Seek Medical Treatment
Get medical attention right away. Your employer may have a network of approved doctors for work-related injuries. Keep all records of treatment and diagnosis. -
Complete a Claim Form (e.g., DWC-1 in California)
Your employer is required to provide you with a claim form. Fill it out and return it to your employer, who then submits it to their insurance company. -
Follow Up With the Insurance Company
Once the claim is submitted, the workers' compensation insurance provider will begin reviewing your case. They may request additional information or schedule medical evaluations. -
Consult a Work Injury Attorney (if needed)
If your benefits are delayed, denied, or don't fully cover your losses, a qualified attorney can help you appeal the decision or explore other legal options.
What is the Deadline to Report a Workplace Injury in California?
In California, you must report a workplace injury to your employer within 30 days of the incident. This deadline is crucial—if you wait too long, you may lose your right to receive workers' compensation benefits.
The 30-day clock usually starts from the date of the injury. However, if the injury or illness developed over time (such as repetitive stress injuries or exposure-related illnesses), the clock starts when you first noticed symptoms or reasonably should have known they were work-related.
Tip: Always report your injury in writing and keep a copy for your records. If your employer doesn't provide you with a workers' compensation claim form (DWC-1), ask for one right away.
Even if you think the injury is minor or you're unsure if you'll need medical treatment, it's still best to report it. Waiting can not only delay benefits—it can give the insurance company a reason to dispute your claim.
If you're past the deadline but have a valid reason (like a serious medical condition or fear of retaliation), speak with a workers' compensation attorney immediately. You may still have options.
What Will Workers' Comp Not Cover?
Workers' compensation will typically not cover injuries that are psychiatric in nature or injuries that are self-inflicted. Injuries that occur while commuting to or from work also don't qualify for workers' comp benefits. Injuries suffered while committing a crime, while under the influence of alcohol and/or drugs or while violating company policies will also most likely not be covered under workers' compensation.
It is also important to remember that if you've suffered a work injury, workers' compensation may not be the only way or ideal option. Make no mistake. You should file a workers' comp claim as soon as you've suffered the injury. But, in many cases, in addition to filing a workers' comp claim, it would also be worth your while to look into whether you have a third-party lawsuit.
What Benefits Can You Receive?
Work injury compensation is designed to help you recover both physically and financially. Depending on your case and jurisdiction, you may be entitled to:
- Medical Expenses: Coverage for hospital visits, medications, surgeries, physical therapy, and ongoing treatment.
- Temporary Disability Benefits: Partial wage replacement while you're unable to work due to your injury.
- Permanent Disability Benefits: Compensation if your injury results in lasting impairment.
- Supplemental Job Displacement Benefits (California-specific): Vouchers for retraining or skill enhancement if you can't return to your previous job.
- Death Benefits: Support for dependents if the injury results in death.
How Third-Party Lawsuits Affect Compensation Claims
So, why do you need to file a third-party lawsuit, and what exactly is it? While workers' compensation will usually cover medical expenses and a portion of lost wages, it will not cover other expenses such as lost future income, loss of earning capacity, future medical expenses you may need such as surgery or physical therapy, and pain and suffering.
This is why many workers claim compensation by filing a lawsuit against a third party, an entity other than the employer. Workers in California are not able to sue their employers in most circumstances. However, they can file a personal injury lawsuit against an entity other than the employer if that entity's negligence caused their injuries. Examples of scenarios that could lead to third party lawsuits include:
Construction accidents: These types of accidents usually result in third-party claims because construction sites involve different people from different companies. For example, if you work for a subcontractor, you may have a third-party claim against the general contractor and construction company whose negligence may have caused your accident. Construction companies and contractors have a duty to workers on their sites to maintain a safe and healthy work environment.
Car accidents: If you were involved in a car accident while driving a company-issued vehicle or performing work-related tasks, you may be able to sue the at-fault driver in addition to filing a workers' compensation claim.
Faulty or defective products: Some work-related accidents occur because a tool or device was defective. For example, defective brakes may cause a forklift accident. A defective nail gun may cause eye injuries or impalement. In such cases, the manufacturers of the defective machinery can be held liable.
Property owners: You may suffer an on-the-job injury when you are on someone else's property. For example, you may slip and fall while on the job or be bitten by a dog on someone else's property while your working. In such cases, you may be able to file a premises liability claim against the property owner and/or the manager.
Tips for Maximizing Your Work Injury Compensation
Want to ensure you receive the full amount you're entitled to? Follow these best practices:
- Report the Injury Immediately: Delays can create doubt and hurt your credibility.
- Document Everything: Keep records of medical treatment, missed workdays, conversations with your employer, and symptoms.
- Follow Medical Advice: Skipping treatment or ignoring doctor's orders can be used against you.
- Avoid Social Media: Insurance companies may monitor your online activity to dispute your claim.
- Speak to an Experienced Attorney: A knowledgeable work injury lawyer can ensure you don't miss deadlines, undervalue your claim, or accept a lowball settlement.
Proving a Work Injury Claim
While workers' compensation is a no-fault system, in a third-party claim, you, the plaintiff, must prove that the other party was negligent. This requires you to prove that the third party was negligent because they owed you a duty of care, that they breached that duty of care and you suffered injuries as a result of that breach or violation of duty.
In addition, you must show evidence that your injuries caused you to suffer monetary damages. Please remember that you can collect workers' compensation while also pursuing compensation for the full extent of your damages against a third party by filing a separate personal injury, product liability, premises liability or wrongful death lawsuit – depending on the circumstances of your case.
Contacting an Experienced Lawyer
If you or a loved one has been injured on the job, it is important that you retain the services of an experienced Los Angeles work injury lawyer who will remain on your side throughout what could be a complicated legal process and help ensure that your legal rights are preserved.
Since the burden of proof in a work injury lawsuit is on the plaintiff, your lawyer will work diligently to secure key evidence in your case that will help strengthen your claim and put you in a position to secure maximum compensation for your injuries, damages and losses. If you have suffered a work-related injury, the knowledgeable attorneys at Greenberg & Ruby can help you better understand your legal rights and options. Call us at (323) 782-0535 for a free consultation and comprehensive case evaluation.
