Workers’ compensation insurance provides important benefits for injured workers. If you suffer any type of injury at work, you are likely qualified to file a claim for benefits through your employer. This process may seem straightforward at first, but many injured claimants encounter unexpected challenges they cannot resolve alone. A California worker’s comp lawyer can be an invaluable asset in your efforts to recover benefits for your injury.
Workers’ Compensation Claim Filing Timeline
After suffering any kind of injury from your work, you have the right to file a claim for workers’ compensation benefits. Almost every worker in the state qualifies for these benefits, as virtually every employer in the state must have workers’ compensation insurance. After an injury, you have 30 days in which to report the injury to your employer, but it is always preferable to report the incident immediately.
Once you report your injury, your employer is required to provide you with the materials needed to file your claim. These include the claim forms that you will need to submit to their insurance carrier and a list of local workers’ compensation physicians you can visit for your medical evaluation. During this evaluation, the doctor you visit will assign you a disability rating that reflects the severity of your injury and your remaining functional capacity to work.
After completing this evaluation, you can submit your claim to the insurance carrier. California law requires all insurance carriers to respond to workers’ compensation claims within 90 days. If you do not receive a rejection notice within 90 days, your claim is assumed to be accepted. Most claimants receive responses within 30 days. However, it is possible for an insurance company to contest a claim and file for an extension of this time limit.
Benefits Available From Workers’ Compensation Insurance
When your claim is approved, the insurance company will send you a determination of benefits explaining the coverage they will provide. The average injured worker can expect two forms of compensation from a successful claim. First is medical expense coverage, which typically includes compensation for all medical treatment costs the claimant incurs for their injury. Second will be disability benefits, which are awarded on a case-by-case basis.
Disability benefits may be paid in partial or total designations depending on a claimant’s ability to work and earn income after their injury. If the claimant retains some ability to work at a diminished earning capacity, partial disability benefits will offset the difference in their earnings until they recover enough to return to their previous earning capacity. Total disability benefits are paid when a claimant cannot work at all.
While most workers’ compensation insurance carriers in the state process claims in good faith, there is always a chance for an insurance company to attempt to take advantage of a claimant, create unnecessary and unreasonable delays in claim processing, or issue lowball settlement offers. Hiring a California workers’ comp lawyer is one of the most effective ways to limit your risk of encountering any such issues and receiving a fair settlement offer for your claim.
FAQs
Q: How Long Does Workers’ Comp Take to Disburse a Settlement Check?
A: The insurance company will review your claim for benefits in California, and if everything is approved, you should receive your settlement check within 30 days. However, the insurance company has the right and the responsibility to investigate your claim to ensure it is legitimate. They may file for an extension, and sometimes, it can take as long as 90 days to receive your first check. Your workers’ comp lawyer is your most valuable asset for streamlining this process.
Q: How Much Will I Receive in Workers’ Compensation Benefits?
A: Your workers’ compensation settlement will include full coverage of all your medical expenses related to your workplace injury. This includes both immediate and future medical treatment costs that you incur as you work toward maximum medical improvement. You will also receive disability benefits that reflect your diminished capacity to work and earn income. It’s possible to qualify for either partial or total disability benefits.
Q: How Long Do I Have to File My Workers’ Compensation Claim?
A: You need to report your injury to your employer within 30 days; otherwise, you lose the right to file your claim with their insurance carrier. The statute of limitations for actually filing your claim is one year from the date the injury occurred. However, the longer you take to file your claim, the more this will cast doubt on your claim’s legitimacy. It’s always preferable to file your claim as soon as possible after your injury.
Q: Will Workers’ Compensation Benefits Cover Surgical Costs?
A: Some severe injuries and medical conditions will require surgery to correct. If this applies to your case, your workers’ compensation benefits can cover surgical costs as well as follow-up care and rehabilitation. Generally, an injured worker can reasonably expect their employer’s insurance to cover all medical treatment costs they incur for their injury, both immediately following their accident as well as ongoing rehabilitative treatment costs.
Q: Will I Win a Larger Settlement if I Hire a Workers’ Comp Lawyer?
A: Hiring legal counsel to assist you with your workers’ compensation claim will dramatically increase your chances of success with the claim. You will also be more likely to streamline the process and receive your benefits more quickly. Additionally, your attorney can verify that the insurance company has issued a fair determination of benefits and help determine whether you have grounds for further legal recourse.
Diefer Law Group can be your trusted legal advocate as you seek compensation for a recent injury at work. We know how difficult it can be for an injured worker to face a complex claim filing process while struggling with their injury, and our goal is to help every client recover as fully as possible as quickly as possible. If you are ready to file your claim for benefits, contact Diefer Law Group today and schedule a free consultation with a California workers’ comp lawyer.
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