Frequently Asked Questions About California Workers’ Compensation

Frequently asked questions about California workers’ compensation

Answers to the questions most commonly asked by employees and employers about workers’ compensation in the Golden State

California’s workers’ compensation laws are complex and ever-evolving. Here are some of the most common questions, along with detailed answers.

Workers’ compensation is a form of insurance that provides benefits to employees injured on the job.

In California, the workers’ compensation system is governed by hundreds of statutes gathered in Title 8 of the California Code of Regulations and the California Labor Code.

Take a glance at these complicated statutes and you’ll understand why employees and employers have questions about workers’ compensation in the Golden State.

Fortunately, we have answers to some of the most common questions. 

Employee questions about workers’ compensation in California

Q: What kinds of injuries qualify for workers’ compensation?

Workers’ compensation covers most injuries that arise during the course and scope of your employment. In other words, if you’re injured while completing an authorized work task, the injury is probably covered.

On the other hand, if you’re injured while doing something outside the scope of your employment (for example, driving home for lunch), the injury is probably not covered.

There are 2 basic types of covered injuries:

  • A traumatic work event. Some injuries are the result of a single event—for example, a roofer who falls from a roof and hurts his back, or an oil worker who’s burned in an oil tank fire.
  • Repeated exposures at work. Some injuries are the result of repeated exposure, such as a secretary who develops carpal tunnel syndrome from repetitive typing, or a construction worker who develops cancer as a result of working with asbestos for decades. 

Workers’ compensation covers some psychological injuries. The law is still developing in this area, but in all psychological-injury cases, an employee must at least show that work was the “predominant” cause of the injury. In other words, if you claim that a traumatic work incident contributed to your depression, you must prove that the event was at least 51% responsible for your depression in order to receive workers’ compensation benefits.

Q: What’s the time limit to file a workers’ compensation claim in California?

The statute of limitations for filing a workers’ compensation claim in California is 1 year from the date of the job-related injury.

However, it’s important to keep in mind that other deadlines must also be met if you want to avoid having your workers’ compensation claim denied. For example, California law requires that you report your work-related injury to your supervisor or some other person in management within 30 days from the date of the injury.

Q: What benefits am I entitled to?

If you’re injured in a work-related accident in California, the following benefits may be available:

  • Medical costs. Covered medical costs include doctor visits, tests, medicines, and physical rehabilitation, among other things.
  • Temporary disability benefits. If your injury prevents you from doing your usual job while recovering, you can receive financial compensation.
  • Permanent disability benefits. If you won’t recover completely, no matter how much treatment you receive, you can receive financial compensation.
  • Supplemental job displacement benefits. You can receive a voucher to help pay for retraining or skill enhancement if you’re eligible to receive permanent disability benefits, your employer doesn’t offer you work, and you don’t return to work for your employer.
  • Death benefits. Dependents of a worker killed as a result of an on-the-job injury can receive death benefits, including weekly financial compensation and money for funeral expenses.

Q: Can I use my own doctor?

Workers who “predesignate” their physician by informing their employer through a written statement or using DWC Form 9783 can use the doctor they select. However, this must be done before the worker suffers the work-related injury.   

If a worker doesn’t predesignate a physician, the worker’s employer is allowed to choose the doctor.

Q: What if my employer wasn’t responsible for my injury?

Workers’ compensation in California is a no-fault insurance system. This means you can recover workers’ compensation benefits even if your employer wasn’t responsible for your injury. There’s only 1 exception to this rule. If you intentionally cause your injury, you can’t recover workers’ compensation benefits.

Q: What happens if my claim is denied or I don’t agree with my benefits?

If you disagree with the decision reached concerning your workers’ compensation claim, you can file a notice of appeal. This notice must be filed within 20 days of the service date of the decision (this date can be found in the lower right-hand corner of the determination letter).

Enjuris tip: You’re not required to hire an attorney to handle your appeal, but an attorney can mean the difference between winning and losing your appeal. Locate a workers’ compensation attorney near you by using our free online directory.

Employer questions about workers’ compensation in California

Q: Do I need to carry workers’ compensation insurance?

All California employers that employ at least 1 person must carry workers’ compensation. Workers’ compensation insurance must be purchased from a licensed insurance company or through the State Compensation Insurance Fund.

Enjuris tip: Information on insurance companies licensed to sell workers’ compensation insurance (including a list of the top 50 workers’ compensation insurers) can be found on the California Department of Insurance (CDI) website.

Q: What about self-insurance?

As an alternative to obtaining workers’ compensation insurance from a licensed insurance company or through the State Compensation Insurance Fund, some employers have the option to self-insure (i.e., assume the financial risk for providing workers’ compensation benefits to employees).

Employers who wish to self-insure must meet the following conditions:

  • The employer must first receive state approval
  • The employer must have a net worth of at least $5 million
  • The employer must have a net income of at least $500,000 per year
  • The employer must post a security deposit
Enjuris tip: Contact your insurance broker or California’s Office of Self Insurance Plans for more information on how to self-insure.

Q: What workers’ compensation notices do I need to give my employees?

You must post the Notice to Employees poster in an open and obvious place at your work site. This notice provides employees with information on your workers' compensation coverage, as well as information on where to get medical care for work injuries.

Failure to post this notice is a misdemeanor that can result in a penalty of up to $7,000 per violation.

Additionally, all employers must provide newly-hired employees with a workers’ compensation pamphlet (also known as a “time-of-hire pamphlet”) explaining their rights and responsibilities.

Q: What do I need to do after an injury occurs?

There are a number of steps employers need to take when an employee is injured on the job:

  • Make sure the employee has access to emergency medical care.
  • Provide a Workers’ Compensation Claim Form (DWC 1) to the injured employee within 1 day of learning of their injury.
  • Once the employee returns the form with the “employee” section filled out, fill out the “employer” section and give the form to the claims administrator and a copy of the form to the employee.
  • Within 1 day of receiving the employee’s filled-out form, authorize up to $10,000 for appropriate medical treatment.
  • Provide transitional work (light duty) whenever appropriate.

Q: I didn’t have insurance and someone was injured. What happens now?

Failing to carry workers' compensation insurance is a misdemeanor punishable by:

  • A fine of at least $10,000, or
  • Imprisonment in the county jail for up to 1 year, or
  • Both

Additionally, if an employee gets hurt or sick because of work and you’re not insured, you’re responsible for paying all bills related to the injury or illness.

Q: Can I just fire the injured employee?

It’s illegal for an employer to fire or otherwise punish an employee for filing a workers’ compensation claim. What’s more, it’s illegal to file or punish co-workers who testify on behalf of the injured employee.

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