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Overview of Workers Compensation Law

Workers Compensation in California

Workers Compensation Insurance is required by law in California that employers carry Workers' Compensation insurance, or qualify under an exception. Workers Compensation is a no-fault system for injuries connected with the employee's employment duties.  This means the injured party need not prove the accident was anyone else's fault, only that the accident occurred at work. Once the injury occurred or after the employee discovered the injury he/she should then notify the employer. At that time injured worker should ask the employer for a Workers Compensation claim form. The injured employee may recover benefits for lost earnings during recovery from an injury, reimbursement of medical expenses, and compensation for any permanent impairment or disability that was caused by the work accident.

Employer Rights in Workers' Compensation

The employer of the injured worker has up to 90 days to investigate and either accept or deny the claim. The employer in a disputed claim, can take up to 90 days to investigate the injured worker's claim and during that time the employer may be allowed to take the injured worker's statement or have the injured worker examined by a physician, or obtain the injured worker's medical records. For injuries after January 1, 2005 the employer must pay for medical care up to $10,000 during the first 90 days.

State Disability Payment in California

If the insurance company fails to provide temporary disability or other workers' compensation benefits, the worker can seek payments from the State of California under the State Disability laws by contacting the nearest Employment Development Office (EDD). The worker can apply for State Disability (EDD) benefits under if they qualify under certain guidelines. 

Workers' Compensation in the Legal System

The Workers' Compensation Appeals Board is the trial court for all industrial injuries involving work related injuries. This is an administrative law proceeding which is held without a jury. A workers' compensation judge makes all of the decisions if the case goes to trial. If you are injured as a result of the fault of someone who is not employed by your employer, you may be able to sue that person in Civil Court, in addition to your action against your employer, under workers' compensation.

Federal Workers' Compensation Law

The Federal Employees' Compensation Act provides workers' compensation coverage to three million Federal and Postal workers including wage replacement, medical and vocational rehabilitation benefits for work-related injury and occupational disease. FECA's low administrative cost means that overhead is only 4% of benefits, and Federal workers compensation costs are only 1.8% of total Federal and Postal payroll, compared to 2.3% for private insurance and state funds.

Serious and Willful Misconduct in Workers' Compensation

An employer act or omission that consists of wanton conduct as to cause the injury of the worker, the employer may be held liable for what is called serious and willful misconduct. The employers conduct must be more than mere negligence.  When such conduct is present damages handed out by the judge may be increased.  It is critical to bring this claim quickly and not wait because the statute of limitations pertaining to serious and willful misconduct is one year from the date of the act or omission in question, causing the injury.

Benefits of Having an Attorney for Workers' Compensation

Workers' Compensation injuries do not require representation by an attorney, but it is highly recommended a qualified attorney represent the injured employee in dealing with employer's Insurance Company.  Many times the Insurance Companies may try to take advantage of inexperienced claimants; this is why an experienced lawyer is crucial.  Employee's are not required to pay any money to the attorney out of their own pocket because the attorney's fees are set by the Workers Compensation Judge in each case.  The attorney will be paid directly by check from the Insurance Company.

If the injured worker cannot settle the claim and purses a judicial proceeding, the case will be heard by the Workers Compensation Appeals Board.  At the trial there is no jury and it is tried only by a worker's compensation judge.  The trial largely consists of testimony of how the injured employee feels and what physical limitations exist.

Common Work Place Injuries Which May Be Covered By Workers' Compensation

Work place injuries happen to employee's who exercise the utmost care.  Unfortunately even the most cautious employees are hurt, workers' compensation legislators in California understands this concept and compensate the injured.  Below is a list of just a few of the more common injuries occurring at work, but any other injury occurring in the work place is covered by workers' compensation.

  • Back injuries
  • Neck injuries
  • Herniated disc
  • Injuries to knees and other joints
  • Ligament tears
  • Carpal tunnel
  • Nerve injuries
  • Rotator cuff tears
  • Broken bones
  • Amputation
  • Internal injuries

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