The Los Angeles Work Injury Attorneys

Workers’ Compensation FAQs

Q: What is workers’ compensation?

A: In general, the law requires all employers in California to carry workers’ compensation insurance that provides benefits to injured workers for medical bills and a portion of their lost wages.

Q: What is a work-related injury?

A: Workers’ compensation laws generally include any injury sustained while you are on the job or performing any duty for your employer’s benefit. This can include errands if performed at the request of and for the benefit of your employer. Accidents in company parking lots and buildings are also usually covered.

Q: What should I do after being injured on the job?

A: Report the injury to your employer/supervisor.

Q: How much time do I have to report my injury?

A: The employee must give notice of injury to the employer within 30 days unless the employer knew or should have known about the injury. Lack of notice will not bar an injured worker from receiving benefits unless the employer shows that it was prejudiced by the applicant’s failure to disclose.

Q: If I file a claim, will I get fired?

A: The law protects injured workers from any form of discrimination by an employer due to their being injured on the job or filing a claim. We have no control over employers, but we can protect an injured worker’s interests if their employer decides to retaliate.

Q: To what benefits am I entitled?

A: Temporary disability, medical bills, permanent disability, medical mileage reimbursement and vocational rehabilitation if you can no longer do the job you used to do.

Q: Can I receive workers’ compensation benefits and state disability at the same time?

A: No, you may collect one or the other.

Q: Can I choose my own doctor for workers’ comp or do I have to go to the company’s doctor?

A: As a general rule, the employer/insurance company can say you need to see their doctor for the first 30 days after notice of injury unless you predesignated your personal physician. After 30 days, you may go to a doctor of your choice.

Q: If I do not like the medical care I am receiving, may I switch doctors within the first 30 days?

A: Yes. Employers lose their right to medical control if they refuse to provide care or give lip service. In this respect, employers must exhibit more than a passive willingness to provide care.

Q: My job involves driving and I had an accident while making a delivery. What rights do I have?

A: If you are injured in a vehicle accident while working for your employer, you are entitled to workers’ compensation benefits, even if you were at fault. If you were not at fault, you may have a separate personal injury claim against the negligent driver of the other vehicle.

Q: Am I entitled to my salary while off work?

A: Most injured employees are not entitled to the entire amount of their regular salary while off work due to a work-related accident. Income benefits while an employee is temporarily disabled or off work are generally computed at two-thirds of the employee’s gross average weekly wage.

Q: Can I sue to recover the difference in salary I lost over and above the disability I was paid by the insurance company?

A: Generally no. Workers’ compensation is a no-fault system. You cannot sue your employer. You are entitled to recover only that portion of your salary provided by workers’ compensation insurance.

Q: Can I work and receive temporary disability at the same time?

A: Generally no, but there are exceptions.

Q: Why is the choice of treating doctor important?

A: Your treating doctor will:

  1. Decide what type of medical care you are allowed.
  2. Determine what kind of work you can do safely while recovering.
  3. Determine your return-to-work date.
  4. Produce medical reports tied to the workers’ comp benefits you get.
  5. Participate in valuing your claim.
  6. Determine what medical treatment you need in the future, if applicable.

Q: What happens after I file the claim form?

A: Before your employer gives the form to a claims administrator, they need to complete and sign the “employer” part of the claim form. This administrator takes care of workers’ comp claims on behalf of employers. It is very common for the administrator to be employed by your employer’s insurance carrier. You must receive a copy of the completed form within one working day after filing, and you should put this document in a safe place. Within 90 days, the claims administrator is supposed to determine how to proceed with your claim.

Q: When do my temporary disability payments begin?

A: Provided that they award you benefits, your first temporary disability payment is due within 14 days after your employer finds out about your job-related injury or illness. Additionally, your treating doctor must state that you can’t do your previous job.

Q: Do I get paid disability for each day I miss from work?

A: Not necessarily. You do not get paid for the first three days off work unless your disability lasts 14 days or more.

Q: Can my first temporary disability payment be delayed?

A: Sometimes. According to the State of California Department of Industrial Relations, if the insurance company cannot determine whether your injury is covered by workers’ compensation, it may delay your first temporary disability payment. If there is a delay, the insurance company must send you a delay letter explaining:

  1. Why you will not receive payments within the first 14 days.
  2. What information the insurance company needs to decide if you are eligible for temporary disability benefits.
  3. When a decision will be made.

Q: What happens if my temporary disability payments are late?

A: The insurance company must pay you an additional 10% of the payment, even if there is a reasonable excuse for the delay. However, there is no penalty if the insurance company sends you a delay letter. In addition, if there is no reasonable excuse for the delay, you could be awarded a substantial extra penalty payment.

Q: When do temporary disability payments end?

A: Temporary disability payments end when: your treating doctor says that you can return to your usual job, whether or not you actually return to work, or you return to your usual job or to modified work at your regular pay, or your treating doctor says that you will never recover completely and that you are permanent and stationary, i.e., your condition neither improving nor getting worse. When temporary disability payments end, the insurance company must send you a letter explaining why the payments are ending. The letter must be sent within 14 days after your final temporary disability payment and must list all temporary disability payments sent to you.

Q: My temporary disability payments stopped without explanation. What should I do?

A: Contact an attorney.

Q: My temporary disability payments stopped because the doctor released me. I still cannot perform my regular work. Are there any other benefits I can receive?

A: Yes, within 14 days of your last temporary disability check, the insurance company must commence either vocational rehabilitation benefits (VRMA) or start advancing permanent disability payments. You may also be eligible for state disability benefits.

Q: What rights do I have if I cannot recover from my injuries?

A: If your treating doctor says that you will never recover completely, you may be eligible to receive permanent disability benefits, vocational rehabilitation services and payments, and lifetime medical care.

Q: How can an attorney help me?

A: Among other things, an attorney can:

  1. Help you obtain the benefits to which you are entitled.
  2. Plan a strategy for your case.
  3. Gather information to support your claim.
  4. Keep track of deadlines.
  5. Represent you in hearings before a workers’ compensation judge.
  6. Inform you about additional available claims and benefits.
  7. Advise you about types of settlements.

Q: How are workers’ compensation attorneys paid?

A: You do not pay your attorney right away. Instead, the attorney’s fee is taken out of your benefits later. As stated by the State of California Department of Industrial Relations, the fee usually ranges from 9% to 15% of your final permanent disability settlement or award, plus an additional amount if you receive vocational rehabilitation benefits. A judge must approve the fee.

Q: When do I need a workers’ compensation attorney?

A: If, among other things:

  1. You believe that your employer or the insurance company is treating you unfairly or withholding benefits.
  2. You have a permanent disability which seriously limits your ability to work or causes great pain.
  3. You are not sure how to proceed with your case.
  4. You are not satisfied with your medical care.

Q: How do I know if I am receiving all my benefits?

A: Workers’ compensation laws provide for benefits which generally fall into three main categories: income benefits, medical care and vocational rehabilitation. Income benefits include temporary total disability, temporary partial disability, permanent partial disability and permanent total disability. Payment of income benefits depends on your medical condition. Medical expenses may include, but are not limited to, doctor’s fees, emergency care, home care, hospital fees, diagnostic or other testing, physical therapy, prescription medication and mileage. You may be entitled to medical expenses even if you do not receive income benefits.

Q: Am I entitled to emergency care?

A: An injured worker is entitled to emergency medical care at the employer’s expense. If you are injured on the job, your medical expenses, including emergency care, should be covered by your employer’s workers’ compensation insurance.

Q: I was injured in Texas, but live in California. Can I file for benefits under California law?

A: If you were hired in California and sent to work in Texas, you fall within California jurisdiction; but If you went to Texas seeking work without any contact while you lived in California, you probably do not fall within California jurisdiction.

Q: Can I recover for my pain and suffering?

A: Workers’ compensation laws do not allow an injured worker to recover from pain and suffering. However, as an injured employee, you are entitled to certain benefits under California law, which generally include temporary and permanent disability, medical care and sometimes vocational rehabilitation.

Q: What if I was injured by someone not working for my employer?

A: In addition to a workers’ compensation claim, you may have a third-party claim. Two common examples of third-party claims involve automobile accidents while on the job and defective products used on the job. Although workers’ compensation is your “exclusive remedy” against your employer, you may be able to file a lawsuit against another party, such as the driver of the other vehicle or the manufacturer of the defective product.

Q: Am I entitled to Social Security Disability benefits?

A: To be eligible for Social Security Disability benefits, you must show that you are unable to perform any type of full-time work for at least 12 months. Benefits are only paid if you prove that you were unable to work at all.

Q: What if I was injured by defective equipment on the job?

A: If you are injured by defective equipment, you may be able to file a product liability suit against the manufacturer. This would be separate from your workers’ comp claim. Although workers’ compensation is your exclusive remedy against your employer, separate claims for defective equipment may be appropriate. If your employer was aware of the defective equipment, additional claims may be filed against them.

Q: Can I still get state disability after I am released from the doctor?

A: Possibly. If you are released with work restrictions and your employer does not have modified work to accommodate your disability, you may be eligible to receive state disability if the funds in your account have not been exhausted.