After years of working in a Cerritos machine shop, you have seen your fair share of accidents. You have even had a few close calls yourself. In reality, it only takes a moment for a catastrophic injury to occur on the shop floor. If you do suffer an injury, do you know what to do? Do you know how the workers’ compensation process works in California? Furthermore, do you even qualify to file a claim?
Filing a workers’ compensation claim can often be a complicated process. Before you start the claims process, it is important to understand how it works so that you can avoid making a mistake that might result in a delay or denial of benefits.
The first step
If you have suffered a work-related injury, the very first thing you should do is to seek medical treatment if it is an emergency. If you do not need immediate medical attention, then find out what doctors in your area are approved by your employer’s workers’ compensation insurance. The next thing you should do is notify your employer of your injury with a signed and written notice. You only have 30 days to do this or you risk an automatic claim denial. Within one day of providing notice, your employer must give you a claim form.
After you file the claim
After you file the claim, your employer or a workers’ compensation insurance representative must give you an authorization for medical treatment within 24 hours. You could be eligible to receive up to $10,000 in medical treatment while the insurer considers your claim. If you do not receive a denial with 90 days of submitting the claim, then you can generally assume that you will receive benefits.
You can appeal a denial
If you receive a denial, you can go through the appeals process and go before a judge for consideration. First, you must file an Adjudication of Claim form along with any documents that the process requires. You will then present your case, and if it remains unsettled, you can go to trial. If the trial does not end in your favor, you can file a Petition for Reconsideration in a final effort to get the benefits you deserve.
If you have suffered a workplace injury, you might be able to file a workers’ compensation claim. However, it is important that you understand how the process works and the time limits you have to file within.