Worker's Compensation Frequently Asked Questions
Based in Lakewood, California, the Law Offices of Dennis R. Fusi, PLC represents injured employees in workers’ compensation claims in Los Angeles County and throughout Southern California. Workers' compensation law defines the rights of workers who are injured at work or become ill or disabled because of a work related injury, and allows injured workers to recover appropriate benefits.
The following frequently asked questions provide some basic information about workers' compensation claims. To learn more about your rights and responsibilities under California law, please contact our offices. Se habla español.
What is workers' compensation?
Workers' compensation is the country's oldest social insurance program. Most states, including California, adopted the program during the 1910s. Workers' compensation is a no-fault system, which means that employees injured at work do not need to prove that another person caused their injury in order to receive benefits. Also, an employee may receive benefits even if he or she caused the accident that led to his or her injury.
What benefits am I entitled to?
Your employer is required by California law to pay for workers' compensation benefits if you get hurt or become ill or disabled because of work. Workers' compensation insurance provides for these basic benefits:
- Medical care
- Temporary disability benefits
- Permanent disability benefits
- Supplemental job displacement benefits or vocational rehabilitation
- Death benefits
Please see our workers' compensation page for further information about these benefits.
What should I do if I get hurt on the job?
First, tell your employer or supervisor right away. If your injury or illness developed gradually, such as carpal tunnel syndrome or hearing loss, report the ailment as soon as you discover that it is work-related. Prompt reporting helps prevent problems and delays in receiving benefits, including medical care that you may need to avoid further injury. If your injury is a medical emergency, go to an emergency room. Your employer may tell you where to go for treatment because in California, your employer may be part of a medical provider network (MPN) set up by your employer's insurance company. If your employer is in an MPN, doctors in the network will administer your treatment unless you were eligible to pre-designate your personal doctor, and did so before your injury occurred. Be sure to tell the healthcare provider who treats you that your injury is work-related.
If I have been injured, when should I fill out a claim form?
After you report your injury to your employer and receive any necessary emergency medical treatment, you should fill out a claim form, which is called a DWC form 1, and give it to your employer. Your employer must give you this form or mail it to you within one working day after learning of your injury or illness. Please see our resources page for links to the Division of Workers' Compensation website, which contains such forms and an abundance of information regarding filing procedures.
Can I be fired for filing a claim?
It is illegal for your employer to fire or punish you for filing a workers' compensation claim if you believe that your injury, illness, or disability was caused by your work. Furthermore, your employer cannot fire or punish your co-workers for testifying in support of your case.
Can I file a claim if I do not have immigration papers, or if I am paid in cash?
The simple answer is yes. All workers injured on the job, including undocumented workers and workers paid “under the table,” are eligible for workers' compensation benefits in California. However, if you do not have immigration papers, you may only receive benefits to cover the cost of medical treatment and, in some cases, lost wages, but not job retraining benefits. We have experience assisting undocumented workers receive the full benefits to which they are entitled under the law.
What if I was injured while running errands for my employer?
If you were running errands for your employer, this task would be considered in the "scope" of your employment. Therefore, any injuries sustained while undertaking this activity would be work-related and covered by workers' compensation. However, if an activity is personal business, and does not further the business of your employer, it is not work-related, and injuries suffered while conducting personal business are not covered by workers’ compensation. These cases are often close calls, and require the knowledge of a skilled workers' compensation and personal injury attorney.
If I have to miss work because of my injury, will I still be paid?
If the treating doctor says that you are unable to return to work right away, you should be entitled to temporary disability benefits while you are off work receiving treatment. If you cannot work at all while recovering, you will likely receive temporary totally disability (TTD) benefits, and if you are able to do some work while recovering, you will likely receive temporary partial disability (TPD) benefits. Generally, the amount of temporary disability benefits is two-thirds of the gross wage you lose while recovering, subject to maximums that change each year.
What if the injury prevents me from performing other work from which I earned an income?
Your gross wages may also include earnings from other work that you did at the time you were injured. This means that your employer may have to compensate you for lost income from other jobs as well. You must give proof of these earnings to your employer's claims administrator, so that he or she may consider all forms of income when calculating your temporary disability benefits.
Will I receive a settlement amount as a result of my injury?
You may be entitled to a settlement amount if you have a permanent disability as a result of your injury. Your case may be settled through an agreement between you and your employer's claims administrator, or a workers' compensation administrative law judge may decide your case after a hearing. Depending on the circumstances of your case and the extent of your disability, you may receive a lump sum payment or an award requiring payments to be made over time. If you have a permanent total disability, you may receive payments for the rest of your life.
What if my employer does not have insurance to cover my injury?
Failing to obtain workers' compensation insurance or self-insure as required by law is a criminal offense. If your employer does not have adequate coverage and you have been injured or become ill or disabled because of work, your employer is responsible for paying all bills related to your injury or medical condition. Only when your employer is properly insured are workers' compensation benefits the sole remedy for injuries sustained on-the-job; accordingly, if your employer is illegally uninsured, you can file a civil suit against your employer as well as a workers' compensation claim.