Every employer in California is required to maintain insurance coverage for workers’ compensation to protect the employees injured on the job. Even an employer with just one employee is required to have insurance coverage. This protection provides coverage for injuries as well as illnesses occurring at work, and often also includes temporary and part-time workers.
It is illegal if the employer fires or punishes any worker for seeking workers’ comp benefits when they believe that the injury or illness was caused on the job. To receive these benefits, the worker is not required to be a legal US resident.
Workers’ compensation is the oldest program for social insurance in the US. Its goal is to provide an injured employee with prompt medical care along with other benefits irrespective of fault.
The program not only reduces costs but also aims to reduce potential conflict between employers and employees that would otherwise result if an employee had to sue the employer and prove fault to recover their benefits.
What to do in case of a workplace injury in California?
If you have suffered an injury at the workplace in a machine-related or another accident in California, you should:
- Call 911 in case of a medical emergency.
- For minor injuries, receive immediate first aid followed by a visit to the doctor.
- Report your injuries to the supervisor.
- Contact an experienced California workers’ compensation attorney for legal advice.
The law in California imposes time limits. Furthermore, you will likely have mounting hospital and medical bills, loss of wages, and worries such as losing your job and supporting your family members. Therefore, it is vital to act decisively and swiftly to protect your rights under California workers’ compensation law to start receiving the benefits.
Benefits Under Workers’ Compensation in California
Under the workers’ compensation law in California, the work comp administrator for the employer is required to pay for all medical expenses which are reasonably necessary to relieve or treat the effects of the machine-related or another workplace injury.
You must receive payment for medical care, regardless of whether you miss any time from work. Make sure to let the medical provider know that your injury is work-related. It is illegal for medical providers to charge an injured worker if they are aware that the injury might be work-related. Don’t get cheated; this is why you need an attorney to make sure you are financially compensated according to the law and morality.
Critical benefits under California workers’ compensation insurance:
- Medical care.
- Benefits for temporary disability – compensation for the time missed at work because of the injury.
- Benefits for permanent disability – compensation for the impairment that continues to restrict your ability to perform regular work in the future even after having received the maximum medical care benefits.
- SJDB or supplemental job displacement benefits – it pays for skill enhancement or job retraining or both at schools approved by the state for workers injured before 2004.
- VR or vocational rehabilitation – it offers retraining or job counseling for workers injured before 2004.
- Death benefits – it provides compensation to dependent survivors if the workplace illness or injury has resulted in a death.
It is vital to understand that California workers’ compensation law does not have any provision to compensate for pain and suffering, as is allowed in case of a personal injury claim against a third party (who is not the employer).
However, if you have suffered a workplace injury because of another’s fault (who is not the employer), then you have a right to pursue a claim for personal injury against that person to recover damages, including pain and suffering.
Amount of Compensation in California
Once you have reported your workplace injury to the employer and filed your claim for workers’ compensation, the insurance company of your employer should start paying your medical treatment benefits. While your claim is under consideration, the insurance company has a legal responsibility to pay your medical expenses up to $10,000, even if the claim is ultimately denied.
Furthermore, if the insurance company does not reject your claim for compensation within 90 days of filing, the law assumes that you are entitled to the benefits.
A Doctor’s Word
If the physician determines that you cannot perform some aspects of your job for a specified period because of your workplace injury, you will be entitled to receive TD or temporary disability. The minimum and maximum TD payments are adjusted every year because they are linked with the average weekly wages in California. For 2018, the minimum is $182.29 per week, and the maximum is $1,215.27.
But these amounts will differ for workers injured before 2018 because for two years following the injury, your maximum TD payment (which applied to the date of your injury) is locked. Beyond two years, if you continue to be eligible for TD payments, the amount will increase to any new higher rate.
If the physician says you can only work for a limited number of hours, you will be entitled to a partial TD payment, which is equivalent to two-thirds of your wage loss per week. If you are eligible for Supplemental Job Displacement Benefits (SJDB), you will receive a benefit comprising a voucher amounting up to $6,000 that applies to certain expenses.
Choosing Your Doctor
Although the work administrator of the employer typically has the right to determine the doctor in the first 30 days, you can receive treatment from your regular healthcare provider if you have appropriately pre-designated your medical group or provider before an injury.
If in the course of your claim, you disagree with the work comp administrator about your medical treatment, you may request a review by a QME (Qualified Medical Examiner). Discuss this with your California machine accident lawyer to learn more about this process. Don’t assume anything – refer to your legal counselor about this and anything related to this.
Personal Injury Claim in case of a Workers’ Compensation Claim
In a usual workers’ compensation claim, the worker may:
- Be injured while operating a machine or lifting a heavy object.
- Fall off a ladder or scaffolding.
- Slip and fall.
- Sustain a severe cut, laceration, amputation or another injury.
- Have an accident with a vehicle or mobile equipment at the workplace.
If this occurs during work, and nobody else is responsible for the injury, the usual remedy is a workers’ comp claim with limited benefits, which are provided as per California Workers’ Compensation Insurance.
But if the worker has suffered an injury due to the negligence or wrongful conduct of another person (who is not the employer), the injured worker may be entitled to damages and additional benefits provided under the personal injury law in California. Most notably, these include damages for the pain, suffering, loss of life’s enjoyment, and inconvenience.
Examples of such personal injury claims may include:
- The worker is driving a vehicle at a construction site or warehouse and is rear-ended by another automobile during work. In such a case, the driver and owner of the other car could be liable.
- The worker is on another person’s premises and is provided with a defective or unsafe ladder, causing the worker to fall and sustain injuries. In such case, the owner of the premises and ladder could be liable.
- The worker is using defective or unsafe machinery, which causes a laceration, amputation, or another type of injury. In this type of situation, the supplier and manufacturer of the defective or unsafe machinery could be liable.
Securing Legal Help
If you believe you may have a workers’ compensation claim or a personal injury claim or both, it is a prudent idea to contact a knowledgeable California lawyer with experience in both workers’ comp and personal injury claims.
Machine Accident Lawyers in Sacramento
I’m Ed Smith, a machine accident lawyer in Sacramento. Workers often get hurt on the job when their machine fails to work due to a manufacturing defect. If you or a loved one has been injured in a workplace accident, call me at (916) 921-6400 or (800) 404-5400 for a free consultation.
I’ve been assisting clients in Sacramento and Northern California with wrongful death and personal injury cases since 1982. My firm is dedicated to helping injured workers get the full compensation they are entitled to.
Photo by pixabay.com
:br cha [cs 1405]