After a serious injury at work, you may be asking yourself: who pays for my medical bills? In California, there are five basic workers’ compensation benefits: medical care, temporary disability, permanent disability, supplemental job displacement, and death benefits. Workers who have been injured on the job in California are entitled to medical care if they file a workers’ compensation claim.
California Workers’ Compensation Laws
Under California Labor Code Section 3700, employers in California are required by law to provide workers’ compensation benefits to their employers. Workers’ compensation benefits cover all workers, including part-time employees. If employers do not provide workers’ compensation to their employees, this is considered a criminal offense in California and is punishable by either a hefty fine of over $10,000 and/or imprisonment for up to one year. In California, the state can also issue penalties of up to $100,000 against employers who are uninsured.
What Type of Medical Care Do I Qualify For?
If you are injured on the job, you qualify for medical care that cures and/or reduces work-related pain or illness. You may be able to visit your own doctor for your work injury unless your employer has established a medical provider network (MPN). An MPN must include a mix of doctors who specialize in work-related injuries and have knowledge in general practice areas. In California, you will be able to choose your own treating physician after 30 days if your employer does not have an MPN.
In the state of California, all employers handling workers’ compensations claims are required to have a program called utilization review (UR). This program has been put in place to determine whether or not a treatment is medically necessary. Doctors in California who treat injured workers must follow medical treatment utilization schedule (MTUS) guidelines. The MTUS lays out fundamental treatments that are scientifically proven to heal or help work-related injuries and illnesses.
What To Do If An Employer Refuses Workers’ Compensation?
An employer may claim that your injury is not that serious or does not qualify for workers’ compensation benefits. If your California employer does not agree to work with you during your workers’ compensation claim process, consult with an attorney immediately. The San Bernardino workers’ compensation attorneys at DiMarco | Araujo | Montevideo have experienced handling complex work injury claims in California.
When Should I File My Workers’ Compensation Claim?
A workplace injury must be reported within 30 days of the accident and a workers’ compensation claim must be filed within one year of the accident. Filing a claim could get more complicated if you think your injury has continued to get worse over time. In that instance, you should report and file your claim when you suffered an ailment (California Labor Code § 5412). For example, when you first saw a doctor or missed work due to illness and/or injury.
An employer must provide you with a DWC-1 form to initiate the claims process for your injury. Information including the date and time of the injury, how it happened, where it occurred, and your symptoms must be documented on the DWC-1 form. Even if the injury seems minor after an accident, it is best to report the injury immediately in case you develop symptoms that later affect your life.