Any workplace injury in California can have various consequences, and the workers’ compensation system exists to help injured workers recover from their injuries as efficiently as possible. If you have recently filed a claim for benefits, you may wonder, “How do I know if my workers’ comp claim is approved in California?”
There are actually several ways you can confirm whether your workers’ compensation claim is approved in California. The team at the Diefer Law Group can assist you with every stage of your case, from gathering the evidence you need to prove your injury or illness is covered to ensuring you are treated fairly and receive an acceptable determination of benefits.
Understanding the Workers’ Compensation Claim Filing Process in California
The Bureau of Labor Statistics recorded about 363,900 nonfatal injuries and illnesses from private industry employees in California during 2023. Of these, 236,700 were classified as severe, meaning injured workers needed time away from work and/or new job placement to account for their medical conditions.
If you are hurt at work, or if you are diagnosed with a medical condition you believe you acquired from your job duties, you have 30 days to notify your employer to ensure you can qualify for workers’ compensation benefits. Once you have reported the injury and received medical care, your employer will provide you with the forms you need to submit to the insurance carrier.
You will likely need to undergo a medical examination from a workers’ compensation doctor before the insurance company will process your claim. After completing this and any other prerequisites, you can submit your claim to the insurance company. You should receive a response within two weeks.
You can contact the insurance company directly if you have not received a response within this time, and it is also possible to contact the California Division of Workers’ Compensation or use their online California Workers’ Compensation Coverage Inquiry tool to check on the status of your claim.
The insurance carrier has a time limit for responding to your claim. They must either reject or approve the claim within a specific timeframe; otherwise, the claim is automatically approved. While the workers’ compensation system in California may appear straightforward at first, the reality is that you could encounter various complications throughout this process, so it’s wise to hire an experienced workers’ compensation attorney to assist you.
How Your Attorney Can Help
Generally, workers’ compensation insurance companies throughout California respond to claims relatively quickly. There is potential for delays when a claim is incomplete, contains inaccurate or inconsistent information, or if an employer disputes their employee’s claim. Having an experienced attorney on your side is a valuable asset throughout all stages of the process.
Your attorney can advise you as to how you can check on the status of your claim. They will know what to do if your employer and/or their insurance carrier raises any disputes against you. If your claim is denied, your attorney can help with an appeal. You may also have additional grounds for legal recourse, such as a third-party personal injury case, and your attorney can help you explore these options as well.
The Diefer Law Group is ready to assist you with every step of the workers’ compensation claim filing process in California. If you encounter any issues with your claim or if the workers’ compensation insurance carrier does not respond in an appropriate time frame, we can explain your options. Reach out to our team at your first opportunity after a workplace injury so we can assist you with your recovery efforts.
FAQs
Q: How Long Does an Insurance Company Have to Respond to a Workers’ Compensation Claim?
A: An insurance company has 90 days to respond to a workers’ compensation claim. If the insurer does not accept or reject the claim or respond to it within this time frame, it will be automatically assumed that the injury is work-related. Failure to meet this time limit could result in additional disability benefits for the injured worker.
Q: How Long Does It Take to Receive Workers’ Compensation Benefits in California?
A: The time it could take to receive workers’ compensation benefits in California varies from case to case, but most claimants who have their claims approved will begin receiving benefits payments within a few weeks of their claims’ approval. Your attorney can help to ensure your claim is handled in a timely manner and that you receive a fair determination of benefits.
Q: How Much Can I Receive in Workers’ Compensation Benefits?
A: The amount you can receive in workers’ compensation benefits will depend on the level of medical care you require and whether the injury prevents you from working during your recovery. Generally, a successful workers’ compensation claim in California yields full medical expense coverage along with disability benefits for the time the claimant cannot work during their recovery.
Q: What Happens if My Workers’ Compensation Claim Is Denied in California?
A: If your workers’ compensation claim is denied in California, you should request a written reason for the denial from the insurance company and then consult a workers’ compensation attorney. You may have grounds to appeal their decision, and you will likely need to file a complaint with the California Division of Workers’ Compensation. You may need to gather evidence to disprove the insurance company’s reason for denying your claim.
Q: Why Should I Hire a Workers’ Compensation Attorney in California?
A: You should hire a workers’ compensation attorney in California to have a better chance of success with your case. When you have an attorney representing you, you are not only more likely to have your claim approved but also more likely to maximize your benefits. Additionally, if you have grounds to file a third-party personal injury case, your attorney can help you win this case and maximize your compensation.
The attorneys at the Diefer Law Group have extensive experience representing California clients in their workers’ compensation cases, and we are confident we can guide you to a positive outcome for your case. If you are wondering about any aspect of the claim filing process, we can provide guidance and support throughout all stages of your case. Contact us today and schedule a free consultation with our team to learn how we can help.
