Workers’ Compensation Benefits: Eligibility Requirements, Injuries Covered, and How to Apply

Workers’ Compensation Benefits: Eligibility Requirements, Injuries Covered, and How to Apply

California’s workers’ compensation is a legal system that ensures sick or injured employees in California get financial and medical benefits. These benefits typically cover the employee’s medical expenses, rehabilitation costs, and lost wages, among other things.

The no-fault system ensures workers can get compensation if they get injured on the job, regardless of who caused the accident. In this article, we will look at the requirements to fulfill to obtain workers’ compensation in California.

Benefits Available Under Workers’ Compensation

There is a wide range of benefits that workers can receive under California workers’ compensation legislation. They include:

• Medical expenses for all medical expenditures incurred due to job-related illness or accident, including hospital stays, doctor appointments, and medication.
• Lost wages for when an employee cannot work due to an illness or injuries stemming from a workplace accident.
• Permanent disability benefits for an employee who becomes permanently disabled due to a job-related disease or accident.
• Vocational rehabilitation benefits such as education for an injured employee who is returning to work.
• Death benefits for employees’ dependents if the employee dies due to a work-related sickness or accident.

Requirements and Qualifications for Receiving Workers’ Compensation Benefits

An employee must fulfill certain requirements to be eligible for workers’ compensation benefits; the requirements typically vary with jurisdiction. “In California, the individual must have gotten injured or fallen sick while working within the scope of their job to be entitled to compensation,” says Attorney Ryan Vego of Glauber Berenson Vego LLP. Otherwise, their illness or injury must have occurred due to the conditions of the working environment.

Furthermore, the employee must have informed their employer of their sickness or accident within a specific time after it happened. Also, the accident or illness must have resulted in the employee going for medical care. In addition, the employee needs to file a workers’ compensation claim with the right insurance company or state agency.

In some cases, the employee may be required to prove that their job caused their illness or sickness. This proof is required if the employer or insurance company is contesting the claim.

Claiming Workers’ Compensation Benefits in California: The Steps Involved

The process of claiming workers’ compensation benefits in California is a long and arduous one, especially without a lawyer. Generally, the steps involved in processing workers’ compensation claims include:

• Report the Injury

The first step is to notify your employer about the sickness or accident within the stipulated time frame, usually within a couple of weeks. Immediately after that or as soon as possible, seek medical attention for your injuries, even if the injuries appear non-life-threatening.

• File a Claim

The next step is to file a claim with the appropriate state agency or insurance company for your workplace. Fill out a claim form alongside the submission of documentation such as medical reports and wage information as proof.

• Investigation

Next, the employer or insurance provider will investigate the employee’s claim. They may require more information or testing to ascertain that the employee’s injuries are work-related or caused by their job.

• Waiting for the Decision

After the investigation on the employer’s part, the next thing is to wait for the decision on the claim. The claim can be accepted or refused, depending on the ability of the employee to establish their case.

If the claim is accepted, the employee will start receiving the workers’ comp benefits. If it is refused, they can file an appeal with the right state agency or insurance company. This appeal may also involve a hearing before a court, depending on the circumstances of the case.

Conclusion

If you were injured while doing your job in California, the workers’ compensation system ensures you can get compensation. However, considering the complexity of the case, you might want to get a workers’ compensation lawyer to assist you.