Workers’ compensation insurance in California protects workers if they are injured or become ill as a direct result of their work. If the worker qualifies for worker compensation benefits, they won’t have to prove fault, so this helps simplify the process for them. However, the process can often get complicated. It helps to know what to expect from workers’ compensation in California so you can prepare for it and make informed decisions through the process. 

Overview of Workers Compensation in California 

Each state has its own workers’ compensation insurance laws. California adopted a workers’ compensation system in the 1910s to protect employees from undue financial strain following an accident or discovery of illness. In California, the workers compensation insurance system is governed by the California Division of Workers’ Compensation (DWC)

Workers’ compensation coverage extends to various industries and professions in California. It plays a vital role in safeguarding the rights of employees and employers. The coverage not only benefits the employees but is also beneficial to the employers as it protects them from potential liability if one of their workers is injured or gets sick at work or while performing work-related duties.  

All employers in California are required to provide workers’ compensation coverage to their employees under the California Labor Code Section 3700. This includes part-time employees. However, independent contractors are typically not covered under workers’ compensation insurance coverage. 

What Benefits are Available in Workers Compensation? 

One of the primary benefits available to eligible workers is medical treatment expenses. This can include expenses for doctor’s fees, hospitalization, surgery, rehabilitation, prescription medication, physical therapy, and other expenses that are necessary or prescribed by a healthcare professional. 

Workplace injuries can result in disabilities. To provide coverage for this, workers’ compensation insurance covers temporary and permanent disability. Benefits are available for both,  total and partial disability. The temporary benefits are only offered long enough to help the injured workers maintain financial stability and resume work. 

The permanent disability benefits are more long-term, but they are not indefinite. The amount and duration of permanent disability benefits in California are determined based on various factors, including the impact of the injury or illness on the earning capacity and the pre-incident income of the injured. 

Eligibility Requirements for Workers Compensation Benefits 

To be eligible for benefits, you need to prove that the injury or illness happened while performing job-related duties. This can include work that was performed at the office or off-site. As long as the work was directly related to and within the scope of the job, you should be covered under workers’ compensation benefits. 

Regardless of the number of employees, most California employers are required to carry workers’ compensation insurance. In cases where their employer is a sole proprietor or the partnership only consists of their spouse, they are not required to carry workers’ compensation insurance. 

If the worker is unable to return to their previous job, then vocational rehabilitation services may be offered to help the worker find work. The vocational rehabilitation services typically include career counseling and assistance in reentering the workforce. In the case of a work-related fatality, workers comp insurance may provide benefits to the deceased worker’s dependents. The most common death benefits include funeral expenses. 

Workers Compensation Claims Process and Dispute Resolution

If you suffered a work-related injury, you should get medical treatment immediately. Once you are in stable condition, you can start the claims process. 

The first step of the claims process is to report the injury or illness to the employer. Failure to notify the employer promptly can result in loss of benefits, difficulty investigating the claim, and other implications for the claims process. 

You will need to file a claim directly with the employer or the employer’s insurance company. Check with the human resources department to find out how to initiate the claims process. The insurance company may want to investigate the case, so you must keep records of how the accident happened, the medical treatment you received, and other evidence to support your claim.

In some cases, workers’ compensation claims are disputed, requiring either negotiation between the parties involved or administrative hearings to resolve the matter. Dispute resolution not only helps address disagreements but can also facilitate faster resolution and help preserve working relationships. 

Does Workers’ Comp Pay for Pain and Suffering in California?

Workers compensation typically does not cover for pain and suffering. This is one of the major limitations of workers’ compensation benefits. The system uses a no-fault rule to ensure a simplified claims process and including pain and suffering into the equation can cause complications. Pain and suffering are more challenging to prove and can delay the process. In addition, it adds costs for the employers and insurance providers. 

If you need pain and suffering compensation, you can consider filing a personal injury claim. Discuss your case with an experienced Workers Comp Lawyer who can guide you on your best legal options.