How to Know if you are Eligible for Workers Compensation Claims

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If you sustained an injury on the job, you may feel confused, stressed and in pain. If you need emergency medical care, that’s the most important thing for your health and safety. Afterward, the next step is to file workers compensation claims. Workers compensation is a type of insurance that your employer is legally required to purchase. If you get injured on the job or develop a work-related illness, you will become eligible for workers compensation benefits. In California, your benefits will typically cover your medical bills and two-thirds of your lost wages.

If you were injured at work and would like to learn more about your rights, it’s important to first understand who is eligible for California workers compensation so you know how to approach your situation.

What Does the Law Say About Workers Compensation in California?

Section 3700 of the California Labor Code states that all employers have to carry workers comp coverage. Regardless of the size of the business or the number of employees, your employer needs to have this coverage.

If your employer is based in a different state and you work remotely or at a California location, the California Labor Code still applies. Your employer will have to meet these requirements.

Your employer must also carry workers comp insurance if you’re a part-time employee, seasonal worker or temporary employee.

You’ll still be eligible for benefits even if your employer breaks the law and doesn’t purchase the necessary coverage. If you’re in this situation, the Uninsured Employers Benefits Trust Fund will cover your medical bills and lost wages.

Are There Situations Where You Wouldn’t Be Eligible for Workers Compensation Benefits?

Workers comp covers plenty of different situations, but there are some events that you can’t file workers compensation claims for:

Sole proprietorship: There is no legal requirement to carry workers comp coverage if you’re the sole proprietor of your business and have no employees. Unless you decided to purchase this coverage for yourself, you wouldn’t be eligible for benefits as a sole proprietor.

Contract work:If you have a contractor status, you might not be covered under your employer’s workers comp policy. In this case, your employer will typically have you sign a waiver.

Accident outside the scope of your normal job:Workers comp covers injuries and illnesses that stem from fulfilling your work-related duties. There are situations where you won’t be eligible for benefits because the claim is for something that happened outside of the scope of your job – for example, if you were using a work truck outside of working hours.

Performing non-work duties offsite but on the clock: You should be covered for an offsite injury as long as you get injured while performing work duties. However, if you leave work during a break to go grab some lunch, for example, and you get injured, you won’t be eligible for benefits.

Intentional injuries and horseplay: Workers comp claims don’t cover intentional injuries, injuries that result from horseplay, or incidents linked to alcohol or drug use.

Fighting: Injuries that result from fighting may or may not be covered. If you initiate the fight, you won’t receive any benefits. However, if you’re the victim of another employee who loses their temper, you can file a claim.

Verifying You Have Coverage

If you’re looking into filing workers compensation claims or want to make sure your employer carries this type of coverage, there are different ways of verifying that you’re eligible for benefits.

Under California law, employers have to display a few posters in the workplace. If you work remotely, you should have received these notices as part of your onboarding package.

Your employer has to display two notices:

  • Notice to Employees – Injuries Caused By Work: Goes over what workers comp coverage is and what to do if you sustain an injury.
  • Notice of Workers’ Compensation Carrier and Coverage: Will have information about the insurer your employer is using.

If you don’t have these documents, reach out to your HR department to get copies.

The Workers’ Compensation Insurance Rating Bureau of California has a website where you can look up your employer. This website will show you any workers comp policies they have purchased over the past five years. It’s a great way to double-check that your employer carries this type of coverage.

Additionally, you’ll get confirmation that you have coverage if you sustain an injury at work. Your employer will file an incident report. They will also give you a claim form known as Form DWC-1. This claim form will come with a packet of information about your rights and the benefits you could be eligible for.

Filing Workers Compensation Claims

California law has extensive provisions for protecting workers. To help you pursue all benefits applicable to your situation, a California workers compensation attorney can help you understand your case, take the appropriate steps and be your advocate. They can help file workers compensation claims for the benefits and compensation you deserve.

Don’t wait to file a claim. There are time limits that you must meet in order to be eligible!

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