File a California Workers’ Compensation Claim in Court
When you are injured at work, your employer is responsible under California law to help you recover from the injuries by paying workers’ compensation benefits. These benefits are payments that cover a variety of different expenses, such as medical bills and lost wages. However, many employees are confused about how exactly they can get these benefits. Employers are often not very forthcoming with details on how to file workers’ compensation claims and may even provide intentionally false information to deter you from filing a claim. There are three main ways to pursue a workers’ compensation claim in California: (1) request reimbursement from the insurance company, or (2) file a case in court.
Filing an Insurance Claim
First, let’s talk about the insurance claim process. California is a very worker-friendly state. There is an entire system dedicated to overseeing and adjudicating workplace injuries. When you suffer an injury at work, you should first notify your supervisor. When your employer is on notice that you were harmed while on-the-job, your employer is then required to follow certain procedures according to California workers’ compensation law and regulations. Your employer must give you a DWC claim form, either in person or by mail, within one business day of being notified of your injury. When you receive the form, you should fill out the section labeled “employee.” Sign the form, make a copy, and send the original either by certified mail or hand-deliver it. Your employer will then fill out the section labeled “employer.” The employer must then give the completed form to its insurance company. Within two weeks, the insurance company should tell you whether your claim has been approved or denied.
Often times, injuries require immediate medical attention. You can’t afford to wait around for slow insurance companies to review your claim documents. The law requires your employer to pay up to $10,000 in medical bills for emergencies, even if the status of your claim has not yet been decided by the insurance company.
Pursuing Compensation in Court
So, what if the insurance company denies your request or does not give you full benefits? You are entitled to an independent review of your claim. If the insurance company outright denies your claim, provides only partial payment, or disagrees about the nature, extent, or treatment of your injuries, you can appeal this decision to DWC. DWC has 24 offices located throughout the state of California, including many in Sacramento, Elk Grove, and other parts of Northern California, and these offices function as trial courts with administrative law judges. First, you must complete and submit an Application for Adjudication of Claim to your home county’s office, then serve a copy on your employer. The DWC will give you a case number. When you receive your case number, you can request a mandatory settlement conference by filing the Declaration of Readiness to Proceed. If you and your employer are unable to negotiate at this first hearing, the judge will schedule a trial.
At this trial before DWC, you will present evidence and call witnesses to testify. The administrative law judge’s decision will come in written format via mail two to three months later. If the judge denies your claim, you can appeal the judge’s decision by filing a Petition for Reconsideration.
Sacramento Workers’ Compensation Lawyer
Even though DWC’s administrative law court is not a Sacramento civil trial court, it contains many of the same formalities and rules. In addition, worker’s compensation law and trial techniques are incredibly complex and require the experience and knowledge of a practiced Sacramento workers’ compensation attorney.
File a Workers Compensation Claim in Court has been brought to you by the Law Offices of Edward A. Smith.
I’m Ed Smith, a Sacramento Workers’ Compensation Lawyer. If you or a loved one has sustained an injury at work, please call me at (916) 694-0002 for free, friendly advice. Read more about us on our website, http://www.AutoAccident.com.
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