If you suffer a workplace injury, Workers’ Compensation can provide financial support for medical expenses and lost wages. However, before you can receive benefits, you must file a Workers’ Compensation claim. The claims process in California involves several steps, which can feel overwhelming—especially while recovering from a serious injury. To protect your legal and financial rights and maximize your benefits, it is highly recommended that you consult an experienced Workers’ Compensation lawyer. A skilled attorney can guide you through each step and address all your questions and concerns.
Steps in the Workers’ Compensation Claims Process in California
If you are injured on the job in Sacramento, the claims process generally follows these steps:
- Notify Your Employer: Report your injury to your employer as soon as possible, ideally immediately, or no later than 30 days after the injury. California law requires timely reporting to be eligible for benefits. Your employer will provide a Workers’ Compensation Claim Form (DWC-1), which you must complete and return. Your employer’s claims administrator will then review your claim.
- Seek Medical Treatment: If you have previously designated a physician with your employer, you may see that doctor. Otherwise, you must choose a doctor from your employer’s Medical Provider Network (MPN) or healthcare organization (HCO). Proper documentation from a qualified physician is critical to supporting your claim.
- Await Claim Determination: Once your claim is submitted, the claims administrator will determine whether to accept or deny it.
- If approved, benefits for medical expenses and lost wages will begin.
- If denied, you can request reconsideration or file an appeal with the California Division of Workers’ Compensation (DWC).
- Continue Medical Treatment: Follow the treatment plan prescribed by your physician. Your doctor will also update your employer on your progress and indicate when you are medically cleared to return to work.
- Determine Eligibility for Disability Benefits: Your claims administrator will review medical reports to determine eligibility for:
- Temporary Disability (TD): For workers unable to perform their job for more than three days.
- Permanent Disability (PD): If you reach Maximum Medical Improvement (MMI) and cannot return to your pre-injury condition.
You may also be eligible for the Supplemental Job Displacement Benefit (SJDB) if your employer cannot provide suitable work.
- Ensure All Benefits Are Paid: Employers and claims administrators must pay medical bills and disability benefits in a timely manner. Disability payments are typically issued bi-weekly, continuing according to the claims administrator’s determination.
Types of Injuries Covered by Workers’ Compensation in Sacramento
Contrary to common belief, Workers’ Compensation is not limited to high-risk jobs. Any employee can qualify if the injury occurs on the job. You do not need to prove employer negligence—only that the injury happened during work duties. Examples include:
- Back and spinal injuries
- Broken bones and fractures
- Burns and deep cuts
- Head trauma and concussions
- Hearing or vision loss
- Heatstroke or cold exposure
- Mental health conditions, including PTSD and anxiety
- Neck injuries
- Repetitive stress injuries (e.g., carpal tunnel)
- Respiratory issues from chemical exposure
- Serious sprains and strains
- Skin disorders from hazardous materials
- Work-related heart attacks or strokes
Statute of Limitations for Filing a Workers’ Compensation Claim
In California, you must file your claim within one year of your work-related injury. Late claims are generally denied. Exceptions include:
- Minor Workers: Statute of limitations begins when the employee turns 18.
- Occupational Illnesses or Injuries: Limitations start when the injury or illness is discovered.
Do You Need a Sacramento Workers’ Compensation Lawyer?
Hiring a Workers’ Compensation lawyer is not legally required, but it significantly increases your chances of receiving maximum benefits. Attorneys handle claim filings, negotiate with insurance companies, and ensure your rights are protected, allowing you to focus on recovery.
Contact Our Skilled Sacramento Workers’ Compensation Lawyers at Walters & Zinn, Attorneys at Law
If you’ve suffered a workplace injury, our Sacramento Workers’ Compensation lawyers at Walters & Zinn, Attorneys at Law can guide you through the claims process. Schedule a free consultation by calling 916-610-4706 or contacting us online. Our offices are located in Folsom and Fairfield, California, serving clients throughout the surrounding areas.