Understanding what to do after sustaining a workplace injury can be confusing, particularly as individuals focus on recovering from their injuries. However, there are various steps that you have to take in order to get the workers’ compensation claim rolling. Here, we want to discuss filing deadlines as well as the steps you are required to take to ensure you receive compensation.
What to do Right After an Injury
The process of filing a workers’ compensation claim in San Bernardino, California, is typically a three-step procedure: reporting the injury, filing the actual claim with the employer, and filing an application for adjudication of claim with the Workers’ Compensation Appeals Board (WCAB).
Reporting the Injury
As soon as the workplace injury occurs, the injured individual needs to seek medical care. If the incident is an emergency, this means going to the emergency room right away. If the injury is not an emergency, the employer or the insurance carrier may have a medical network provider that you need to go see. However, you still need to see a doctor the same day the injury occurs, or the day you discover the injury or illness.
You need to tell the physician treating the injury that the injury is work-related so that they can mark this down in their notes. As soon as possible, you need to make sure that your employer knows about the injury or illness. It is important to point out that workplace injury or illness victims are required to report the injury to their employer within 30 days from when the incident occurs, from when the individual discovers the injury or illness, or from the date of diagnosis.
Then, you should reach out to a San Bernadino workers’ compensation lawyer right away.
Filing the Workers’ Comp Claim
Reporting a workplace injury and it seeking initial medical care does not necessarily mean that the workers’ compensation claim has been filed. In fact, individuals have up to one year from the date an injury or an illness is discovered to file the workers’ comp claim.
However, within one day after individual reports their injury or illness, the employer should give the individual a workers’ compensation claim form, known as Form DWC-1. The employer should also give the employee information about their rights and eligibility for benefits as well as other details about the work injury process.
Individuals who do not receive this form from their employer can download it online from the California Workers’ Compensation (DWC) website.
The worker should fill out the employee portion of the form and list every part of their body that has experienced an injury or illness. The form can be returned to the employer.
Application for Adjudication of Claim
If the insurance carrier has begun paying medical and disability benefits, this does not necessarily mean that the job is done. Disagreements about benefits are not uncommon, even after a claim has initially been accepted. This is particularly true if the medical condition changes and you require additional or extended treatment. Even if you have filed the claim with your employer, we still encourage you to open a case with the WCAB by filing the Application for Adjudication of Claim. Generally, this form must be filed within one year after:
- The date the injury occurred or illness was diagnosed
- The last day when the employer provided medical benefits, or
- The day when temporary disability benefits ended
There are various exceptions to when this application has to be filed, and we strongly encourage you to speak to your attorney, particularly if you have any complications recovering compensation from the insurance carrier.