California Workers' Comp

How To Take Charge When You're Injured On The Job

California Workers' Comp

http://www.nolo.com/products/california-workers-comp-work.html?utm_campaign=nolo-related-products&utm_content=pid|1087||pa|disability||ref_url|www.lawfirms.com/resources/disability/disability-maine.htm||sku|work10&utm_medium=nolo&utm_source=nolo-content

Select Your Format

eBook (Downloadable)

Format: PDF, EPUB, MOBI

Price: $39.99 $27.99

You Save: $12.00 (30% discount)

Book

Price: $39.99 $31.99

You Save: $8.00 (20% discount)

California Workers' Comp

Get the benefits you're entitled to

, Attorney

, 11th Edition

California Workers' Comp shows you how to handle a California workers' compensation claim from start to finish. You'll learn how to work with your insurance company to receive the medical treatment and benefits you deserve. Find out how to:

  • file a claim
  • get the benefits you're entitled to
  • deal with uncooperative employers, doctors and insurance agencies

Get the workers' compensation benefits you're entitled to!

If you’re having a hard time getting workers’ compensation benefits, you’re not alone. Employers’ insurance companies often try to give employees the runaround.

With California Workers’ Comp, you can take charge of your case. It shows you how to:

  • file your claim
  • find qualified, sympathetic doctors
  • get paid while you're off work
  • deal with stingy insurance companies
  • negotiate a lump-sum settlement
  • present your case at a hearing, if necessary, and
  • get help with retraining so that you can work again.

Whether you hire a lawyer or not, this book will help you estimate the benefits you should receive and understand the process. The 11th edition is completely updated with dozens of forms and the latest regulations.

Nolo has dozens of products created just for California residents. Check out Nolo's list of California products.

 

“A great hands-on guide for dealing with workers’ compensation cases."  -Orange County Register

"Nolo has published incredibly useful lay guidebooks and consumer software on legal issues [since 1971]." -San Francisco Chronicle

ISBN
9781413322699
Number of Pages
456
Included Forms

    Forms to File With the Division of Workers’ Compensation

    • DWC-1: Workers’ Compensation Claim Form
    • Application for Adjudication of Claim
    • Application for Adjudication of Claim (Death Case)
    • Declaration in Compliance With Labor Code Section 4906(G)
    • Subpoena Duces Tecum
    • Subpoena
    • Declaration of Readiness to Proceed
    • Declaration of Readiness to Proceed to Expedited Hearing (Trial)
    • Pre-Trial Conference Statement
    • Notice of Change of Address
    • Proof of Service
    • Document Cover Sheet
    • Document Separator Sheet
    • Cover Letter to Workers’ Compensation Appeals Board
    • Record of Income and Benefits Received
    • Record of Time Off Work
    • Record of Medical Expenses and Request for Reimbursement
    • Medical Mileage Expense Form
    • Settlement Worksheets and Documents
    • Settlement Worksheet: Value of Workers’ Compensation Claim
    • Stipulations with Request for Award
    • Compromise and Release
    • Minutes of Hearing
    • Request for Consultative Rating

    Forms to File With Your Employer

    • Employee’s Designation of Personal Physician
    • Letter to Employer Requesting Copies of Documents and Evidence
    • Objection to Treating Physician’s Recommendation for Spinal Surgery 
  • Christopher Ball

    Attorney Christopher A. Ball is the author of California Workers' Comp: How to Take Charge When You Are Injured on the Job, now in its eighth edition. Since 1991, Mr. Ball has practiced workers' compensation law exclusively. He is certified as a Worker's Compensation Specialist with the State Bar of California. Mr. Ball received his bachelor's degree in Business Administration from Long Beach State in 1972 and graduated law school from Western State School of Law in 1975.

Part I: All About Workers’ Compensation

1. Introduction to Workers’ Comp

  • A. What Is Workers’ Compensation?
  • B. What an Injured Worker Is Entitled To
  • C. Where to Get Additional Information and Help
  • D. How to Use This Book
  • E. What This Book Does Not Cover

2. Overview of a Workers’ Compensation Claim

  • Step 1. Notify Your Employer of the Injury
  • Step 2. Get Medical Treatment If Needed
  • Step 3. Paying for Medical Treatment If Your Employer Denies Your Claim
  • Step 4. Tell the Doctor About Your Injuries
  • Step 5. The Doctor Decides Whether You Need Time Off
  • Step 6. Complete Workers’ Compensation Claim Form and Application for Adjudication of Claim Form
  • Step 7. Secure Control of Your Medical Care
  • Step 8. You May Receive Temporary Disability Benefits
  • Step 9. Handling a Denial of Your Claim or Benefits
  • Step 10. Taking Problems to the Appeals Board
  • Step 11. After It Is Determined That You Have Reached Maximal Medical Improvement (MMI)
  • Step 12. You May Recover Completely and Return to Work
  • Step 13. You May Be Entitled to Supplemental Job Displacement Benefits
  • Step 14. You May Be Partially Permanently Disabled
  • Step 15. Go to Trial If There Is No Settlement
  • Step 16. Judgment Is Paid or the Matter Is Appealed

3. Is Your Injury Covered by Workers’ Compensation?

  • A. Is Your Job Covered by Workers’ Compensation?
  • B. Do You Have a Compensable Injury?
  • C. Injuries Not Covered by Workers’ Compensation

4. Cumulative Trauma Disorders

  • A. What Is a CTD?
  • B. Becoming Aware of Your Injury
  • C. Diagnosis and Treatment
  • D. Recovery and Permanent Injuries
  • E. Returning to the Workforce
  • F. Further Medical Treatment

Part II: Protecting Your Rights

5. What to Do If You’re Injured

  • A. Request Medical Treatment
  • B. Report the Injury Within 30 Days
  • C. File Your Workers’ Compensation Claim
  • D. The Insurance Company’s Answer
  • E. Take Steps to Protect Your Rights

6. Keep Good Records to Protect Your Claim

  • A. Set Up a Good Record-Keeping System
  • B. Read and Understand What You Receive in the Mail
  • C. Gather Important Records Pertaining to Your Claim
  • D. Request Copies of Documents and Evidence
  • E. Keep Your Address Current

7. The Insurance Company’s Role

  • A. Self-Insured Employers
  • B. The Insurance Company’s Responsibilities
  • C. Your Responsibilities as an Injured Worker
  • D. Who’s Who in the Insurance Company
  • E. How to Deal With the Insurance Company
  • F. Tactics Insurance Companies Use to Deny or Minimize Claims
  • G. Settling Your Case

8. Dealing With Your Employer

  • A. Self-Insured Employers
  • B. The Employer/Insurance Company Relationship
  • C. The Employer’s Responsibilities
  • D. If You’re Out of Work Due to the Injury
  • E. Bankruptcy or Other Employer Financial Problems

9. Taking Charge of Your Medical Case

  • A. What the Treating Doctor Does
  • B. Choose Your Treating Doctor (Get Medical Control in Your Case)
  • C. Be Sure You Receive Excellent Medical Care
  • D. Changing Treating Doctors
  • E. When Your Condition Becomes Permanent and Stationary (P&S) or Has Reached Maximal Medical Improvement (MMI)

10. Medical-Legal Evaluations

  • A. Rules for Medical-Legal Evaluations
  • B. Compensability of Injury (Labor Code § 4060)
  • C. Nature and Extent of Permanent Disability or Need for Future Medical Treatment (Labor Code § 4061)
  • D. Other Issues to Be Resolved by Medical-Legal Evaluations (Labor Code § 4062)
  • E. Picking a Qualified Medical Evaluator (QME)

Part III: Workers’ Compensation Benefits

11. Medical Benefits

  • A. Limitations on Medical Treatment
  • B. Payment for Current Medical Treatment and Evaluations
  • C. Future Medical Care Costs
  • D. Penalties

12. Temporary Disablity Benefits

  • A. Qualifying for Temporary Disability
  • B. Amount of Temporary Disability Payments
  • C. How Payments Are Made

13. Permanent Disability (and Life Pension)

  • A. How Permanent Disability Payments Compensate You
  • B. Kinds of Permanent Disability Awards
  • C. Establishing Your Permanent or Maximal Medical Improvement Disability Status
  • D. How Permanent Disability Benefits Are Paid
  • E. Amount of Permanent Partial Disability Benefits
  • F. Life Pension Benefits
  • G. Permanent Total Disability Benefits

14. Supplemental Job Displacement Benefit

  • A. Supplemental Job Displacement Benefits and Offers of Alternative or Modified Work
  • B. Supplemental Job Displacement Vouchers for Injuries in 2013 or Later
  • C. Supplemental Job Displacement Benefit for Dates of Injury in 2004 Through 2012
  • D. Return-to-Work Program

15. Death Benefits

  • A. Who May Receive Death Benefits
  • B. Death Benefit Amount
  • C. Additional Payments for Dependent Minor Children
  • D. Burial Expense for Deceased Worker
  • E. Unpaid Temporary or Permanent Disability Payments
  • F. How Death Benefits Are Distributed

16. Extraordinary Workers’ Compensation Benefits and Remedies

  • A. Subsequent Injuries Benefits Trust Fund
  • B. The Uninsured Employers Benefits Trust Fund
  • C. Discrimination Benefits (Labor Code § 132(a))
  • D. Employer’s Serious and Willful Misconduct

17. Benefits and Remedies Outside the Workers’ Compensation System

  • A. State Disability Insurance (SDI)
  • B. Social Security Benefits
  • C. Claims or Lawsuits for Personal Injuries
  • D. Claims or Lawsuits Based on Discrimination

Part IV: Settling Your Case

18. Rating Your Permanent Disability

  • A. Obtaining a Rating
  • B. What Is Involved in the Rating Process?
  • C. How to Rate a Disability Using the New Rating Schedule for Injuries in 2013 or Later
  • D. How to Rate a Disability Using the 2005 Rating Schedule
  • E. Other Considerations in Rating a Permanent Disability
  • F. How to Rate a Disability Using the Old Rating Schedule

19. Figure Out a Starting Settlement Amount

  • A. What You May Receive in a Settlement
  • B. Two Kinds of Settlements
  • C. Determine the Value of Your Claim Using the Settlement Worksheet
  • D. What to Do Next

20. Negotiating a Settlement

  • A. Deciding Whether to Negotiate Your Own Settlement
  • B. The Concept of Compromising
  • C. How to Negotiate a Settlement
  • D. Review and Sign Settlement Documents
  • E. Attend an Adequacy Hearing

Part V: The Workers’ Compensation Appeals Board

21. Preparing Your Case

  • A. Identify Possible Issues in Dispute
  • B. How to Prove (or Disprove) Disputed Issues
  • C. Depositions
  • D. Subpoenaing Witnesses and Documents
  • E. Preparing for a Pre-Trial Hearing
  • F. Preparing for a Trial

22. Arranging for a Hearing or Trial

  • A. Kinds of Hearings
  • B. Trial on Preliminary Issues
  • C. Trial on Entire Case (the Case-in-Chief)
  • D. File a Declaration of Readiness to Proceed to Set Your Case for Hearing
  • E. Copy, Serve, and File Documents
  • F. Receiving Notice of a Hearing

23. How to File and Serve Documents

  • A. What Is Service of Documents?
  • B. How to Serve Documents by Mail
  • C. How to Serve Documents Personally
  • D. How to Serve Documents by Fax
  • E. How to File Documents With the Workers’ Compensation Appeals Board

24. Going to a Hearing or Trial

  • A. Finding Your Way Around the Appeals Board
  • B. Pre-Trial Conferences
  • C. Trial
  • D. Findings and Award

25. Appealing a Workers’ Compensation Decision

  • A. The Three-Step Appeal Process
  • B. Petition for Reconsideration
  • C. Writ of Review With the Appellate Court
  • D. Writ of Appeal to the California Supreme Court

Part VI: Beyond This Book

26. Lawyers and Other Sources of Assistance

  • A. Information and Assistance Officers
  • B. Hiring a Lawyer

27. Legal Research

  • A. Find a Law Library
  • B. The Basics of Legal Research

28. Case Law Review

  • Chapter 3—Is Your Injury Covered by Workers’ Compensation?
  • Chapter 5—What to Do If You’re Injured
  • Chapter 9—Taking Charge of Your Medical Case
  • Chapter 10—Medical-Legal Evaluations
  • Chapter 11—Medical Benefits (Treatment)
  • Chapter 12—Temporary Disability Benefits
  • Chapter 13—Permanent Disability (and Life Pension)
  • Chapter 14—Supplemental Job Displacement Benefit
  • Chapter 15—Death Benefits
  • Chapter 16—Extraordinary Workers’ Compensation Benefits and Remedies
  • Chapter 18—Rating Your Permanent Disability
  • Chapter 19—Figure Out a Starting Settlement Amount
  • Chapter 20—Negotiating a Settlement
  • Chapter 21—Preparing Your Case
  • Chapter 22—Arranging for a Hearing or Trial
  • Chapter 24—Going to a Hearing or Trial

Online Appendixes and Forms

  • Editing RTFs

Index

Chapter 1
Introduction to Workers’ Comp

A. What Is Workers’ Compensation?

B. What an Injured Worker Is Entitled To

     1. Workers’ Compensation Benefits

     2. Take an Active Role in Obtaining Benefits

     3. Other Benefits and Remedies

C. Where to Get Additional Information and Help

     1. Information and Assistance Officers

     2. Workers’ Compensation Insurance Rating Bureau (WCIRB)

     3. Division of Workers’ Compensation Website

D. How to Use This Book

E. What This Book Does Not Cover

 

Over the years, I have advised many injured workers about how the law applies to their particular workers’ compensation claim. I have yet to talk to an injured worker who felt that the workers’ compensation laws were fair or adequate. There is good reason for this. Legal limitations and restrictions as to how much an injured worker may recover result in many workers receiving inadequate benefits. Unfortunately, the workers’ compensation system was not designed primarily to benefit the injured worker. Instead, it was created to protect employers and workers’ compensation insurance companies by limiting their legal liability and obligations.

Despite these negatives, workers’ compensation has evolved over the years to include some decent worker protections. Although many of these are buried in hard-to-understand rules and procedures, informed workers who understand how the system works and are willing to assert their rights have a good chance of being treated fairly. Sadly, most workers have little, if any, knowledge about their workers’ compensation rights. This book aims to change that.

 

Legal Citations

Throughout this book, you’ll see references to laws that govern the California workers’ compensation system. If you want more information, you can look up these legal citations, as explained in Chapter 27.

Labor Code (LC). The vast majority of workers’ compensation laws are contained in the California Labor Code, the basic state laws that regulate employment matters.

California Code of Regulations (CCR). These rules and regulations expand upon, interpret, and explain procedures for implementing and enforcing the California Labor Code.

United States Code (USC). Many laws that apply to people not covered by California workers’ compensation laws can be found in the United States Code.

 

This book can help you if you’re handling your own workers’ compensation case or filing a claim on someone else’s behalf, such as a minor. (In legal terms, this is referred to as acting in the capacity of a guardian ad litem, where you file a workers’ compensation claim on behalf of a minor or someone who is incompetent.) If you’re represented by an attorney, being well informed about workers’ compensation procedures and the important decisions you’ll need to make will help your lawyer guide you through the process.

A. What Is Workers’ Compensation?

Workers’ compensation is a system of benefits set up to help employees who are injured on the job. (And, if a worker dies as a result of work injuries, the employee’s dependents are entitled to receive workers’ compensation death benefits.)

Work-related injuries (and occupational illnesses and diseases) are also referred to as “industrial injuries.” For workers’ compensation purposes, an industrial injury is any injury—in any occupation—that occurs as a result of your employment. Put another way, “industrial” is synonymous with “work.” You may also hear the term “compensable injury,” another term that refers to an injury that’s covered by workers’ compensation.

 

Workers’ Compensation Jargon

In few places on earth will you find a system that uses as much confusing, contradictory, and just plain batty terminology as workers’ compensation. Unfortunately, you will simply have to master a number of confusing terms and acronyms used in the workers’ compensation system, or you won’t understand how to handle your claim. Whenever you hit a mind-boggling term, take a moment to learn what it means. In no time at all, you’ll be talking with ease about your TTD, QME, PQME, MMI, and QRR.

 

Workers’ Compensation Fraud

Over the last several years, alleged workers’ compensation fraud (the filing of false claims) has been a major concern of employers and workers’ compensation insurance companies alike. In response to these concerns, California passed major revisions to its workers’ compensation laws, which are incorporated in this book. It is now a felony for anyone to knowingly file a false or fraudulent workers’ compensation claim. The maximum fine for workers’ compensation fraud is $150,000, or twice the amount of the fraud, whichever is greater. (Insurance Code § 1871.4.)

The laws that make it harder to commit fraud unfortunately also make it much more complicated for injured workers to file and receive compensation for legitimate claims.

 

The workers’ compensation system is sometimes described as a “no-fault” system of give and take. The injured employee gives up the right to sue an employer in court. In return, the employee receives compensation without having to prove that the employer caused the injury—the only thing that matters is that the injury occurred at work. In exchange for providing compensation regardless of fault, the amount the employer must pay is limited to benefits specified in the California Labor Code. Not surprisingly, these amounts are almost always significantly less than what might be available if employees could sue in court. For the vast majority of cases, the rule that work-related injuries must go through the workers’ compensation system is a fact of life. (There are a few situations where an injured employee is not covered by workers’ compensation and may sue an employer in the regular court system; see Chapter 17 for a discussion.)

At first glance, a no-fault system sounds like a fair deal—workers who are hurt are taken care of without having to go through a costly process of assigning blame. Unfortunately, the existing system is complicated and hard to understand. It has evolved into what too often becomes a bureaucratic nightmare that intimidates and hinders people with valid claims. But perhaps the worst aspect of the California workers’ compensation system is that it doesn’t deliver on its fundamental promise to cover all injured workers on a no-fault basis. The employer and its workers’ compensation insurance company will often fight an employee’s perfectly legitimate claim every step of the way.

B. What an Injured Worker Is Entitled To

Enough about the problems with workers’ compensation laws. If you’ve been injured on the job, you probably want to know how you’ll be compensated. California workers’ compensation laws provide a limited number of benefits (mostly money payments). Workers’ compensation benefits are tax exempt; in other words, they are not considered income for income tax purposes.

1. Workers’ Compensation Benefits

This summary discusses what is available and refers you to the chapters that explain how to obtain and make the best use of available benefits:

Medical treatment and related costs. You are entitled to medical treatment, at no cost to you, to cure and relieve the effects of your industrial injury. You are entitled to up to $10,000 worth of medical treatment for the first 90 days after filing your claim or until the insurance carrier denies your claim, whichever comes first. Of course, if the insurance company accepts your claim, it will continue to pay for your medical treatment.

If your claim is denied, you will have to obtain medical treatment on a lien basis (discussed in full in Chapter 9, Section B2b).

You are also entitled to be reimbursed for mileage costs going to and from your medical appointments. You are not, however, entitled to mileage reimbursement for attending court hearings or traveling to the insurance company’s office. (Chapters 9, 10, and 11 cover all aspects of medical benefits.)

Temporary disability. You are entitled to receive monetary payments while you are off work and temporarily disabled due to your injury. The amount of temporary disability is based upon two-thirds of your average weekly wage, with established maximums, depending upon the date of your injury. In short, don’t expect to receive as much money as when you were on the job. (See Chapter 12.)

Permanent disability. If your injury affects your ability to participate in the job market in the future, you may receive a set dollar amount as compensation. How much you’ll receive is determined by the part of your body that is injured, your age, your occupation, and any work restrictions as determined by various doctors. These factors are plugged into a standard rating schedule to determine how much you can recover. If you’re 70% to 99.75% disabled, you may additionally receive a small pension for the rest of your life. If you’re 100% (totally) disabled, the amount you are entitled to receive increases substantially. (See Chapter 13.)

Supplemental job displacement. The supplemental job displacement benefit is available to workers injured in 2004 or later. This benefit, available only to workers whose employers did not offer them modified or alternative work, provides a $4,000 to $10,000 voucher for education-related retraining and skill enhancement at state-approved or accredited schools. (See Chapter 14.)

 

CAUTION

If you were injured years ago. If you have a claim for an old injury that occurred prior to 1/1/04, you are not entitled to Supplemental Job Displacement Benefits. You used to be able to get a benefit called Vocational Rehabilitation Benefits, but that benefit was revoked, effective 1/1/04, and nothing was created to replace it for injuries before 1/1/04.

Death benefits. If you were a total or partial dependent (someone who relied upon another person for support) of an employee who died as a result of an industrial injury, you may have the right to recover certain benefits, including burial expenses and a sum of money. (See Chapter 15.)

Other Workers’ Compensation Benefits

In unusual circumstances, you may be entitled to benefits that are not available in a typical workers’ compensation claim. Turn to Chapter 16 if any of the following remedies may apply to your situation:

Subsequent Injuries Benefits Trust Fund. You may be eligible if you had a prior injury or illness before your present workers’ compensation injury, regardless of whether the prior injury happened at work.

Uninsured Employers Benefits Trust Fund. This fund is available if your employer does not have workers’ compensation insurance and is not self-insured.

Discrimination benefits under LC § 132a. You may be eligible to file a separate claim if your employer discriminated against you because you asserted your right to file a workers’ compensation claim.

Employer’s serious and willful misconduct. You may qualify for increased benefits if your employer’s seriously improper action or inaction—such as the failure to remedy an obvious safety violation—contributed to or caused your work injury.

 

2. Take an Active Role in Obtaining Benefits

It’s a fact of life that you’re the one who must see to it that the insurance company provides you with benefits. If you (or your attorney, if you have one) don’t go after all the benefits to which you are entitled, you will likely be shortchanged. In the workers’ compensation system of limited benefits, you cannot afford to be complacent.

Lest you let your pride get in the way, clearly understand that workers’ compensation benefits should not be considered charity or welfare. Whether you like it or not, the existence of the workers’ compensation system means that you have given up valuable legal rights. For example, you cannot sue your employer, you are not entitled to payments to cover lost wages (past, present, or future), and you cannot receive compensation for your pain and suffering.

Accept workers’ compensation benefits for what they are: part of a system set up to get you medical treatment for your injury, provide minimum income while you are off work, and help you get back to work in some capacity as soon as possible.

3. Other Benefits and Remedies

You may qualify for benefits and remedies outside the workers’ compensation system, including:

State disability (SDI). Most workers have a small amount deducted from each check for “SDI,” or State Disability Insurance. In the event of disability for any reason (work or otherwise), you may be entitled to disability payments. SDI is usually paid where workers’ compensation temporary disability is not being paid. (See Chapter 17, Section A.)

Social Security benefits. If your injury is severe enough, you may qualify for Social Security disability, which is paid by the federal government. (See Chapter 17, Section B.)

Claims or lawsuits for personal injuries. If your work injury was caused, entirely or in part, by an outside third party (someone not working for your employer), you may be able to sue that person or entity in civil court for damages. (See Chapter 17, Section C.)

Claims or lawsuits based on discrimination. In some instances where you have experienced discrimination, you may be able to file a claim under the Americans with Disabilities Act, the California Fair Employment and Housing Act, or other laws. (See Chapter 17, Section D.)

C. Where to Get Additional Information and Help

While this book may answer many of your questions, it’s quite possible that you’ll need further assistance. You may contact any of the agencies listed below for help. In addition, Chapter 27 provides information on how to make use of the law library and the Internet to do legal research. If you decide that you want to be represented by an attorney, you may also find Chapter 26, on working with lawyers, helpful. Be aware, however, that it may be difficult to find a workers’ compensation attorney willing to take your case, as lawyer fees are relatively low and most workers’ compensation attorneys have many more cases than they can handle.

1. Information and Assistance Officers

The Workers’ Compensation Appeals Board is the place where documents in your case are filed and where your matter is heard by a workers’ compensation judge. Despite its name, all workers’ compensation matters (not just appeals) are handled by the Workers’ Compensation Appeals Board, also known as the appeals board or the WCAB. There are approximately 18 appeals boards in the state of California.

Each Workers’ Compensation Appeals Board has at least one information and assistance officer (also called an I&A officer), whose job is to give you free help in pursuing your workers’ compensation claim. The information and assistance officer’s role is to assist injured workers in navigating their way through the workers’ compensation system. Some I&A officers can be your best source of information and help in resolving problems you encounter.

The number of your local workers’ compensation office is available on Nolo’s website. (See Chapter 29, “Online Appendixes and Forms,” for the link to Appendix 1: “Workers’ Compensation Office Addresses and Code Lists.”) You may also get helpful general information from the automated Workers’ Compensation Information and Assistance Unit line at 800-736-7401, which provides prerecorded information about workers’ compensation.

In addition, “Injured Worker Workshops” are held every month at every district office. These free one-hour workshops consist of a presentation by an information and assistance officer followed by a question and answer session. Call your district office for dates and times.

2. Workers’ Compensation Insurance Rating Bureau (WCIRB)

The Workers’ Compensation Insurance Rating Bureau (WCIRB) is helpful in finding out who your employer’s workers’ compensation company was at the time of your injury. Here’s where to reach the WCIRB:

Workers’ Compensation Insurance Rating Bureau

525 Market Street

Suite 800

San Francisco, CA 94105

415-777-0777

3. Division of Workers’ Compensation Website

The Workers’ Compensation Division has developed a helpful website at www.dir.ca.gov/DWC/dwc_home_page.htm. Here you can find an overview of workers’ comp laws and rules, a FAQ (frequently asked questions) area, and guides for injured workers on topics such as how to object to a summary rating, how to file an appeal, and how to fire your attorney. This site also provides workers’ compensation forms and the manual for rating permanent disabilities, in PDF format.

D. How to Use This Book

 

Find it Online

Forms online. All of the forms, tables, and lists of district workers’ comp offices contained in this book can be found for free for users of this book on Nolo’s website. (See Chapter 29, “Online Appendixes and Forms,” for the link to these pages.) In addition, if workers’ comp laws or forms change before the next edition of this book, you’ll find updates to the book on this Web page.

No two injuries are alike, and no two injuries are ever handled the same way by the same insurance company, let alone by different companies. How much of this book you’ll choose to read will depend on your individual circumstances.

I suggest that you read Chapter 2 (“Overview of a Workers’ Compensation Claim”) to get a good understanding of the workers’ compensation system, and to determine where your claim is in the system. Read Chapter 21 (“Preparing Your Case”) in conjunction with Chapter 2, as trial preparation should begin on day one of your claim and continue until the day of the trial.

If you have a cumulative trauma or a repetitive stress injury, read Chapter 4 (“Cumulative Trauma Disorders”).

A thorough reading of Chapter 6 (“Keep Good Records to Protect Your Claim”) will ensure that you properly prepare and maintain the information you will need for trial.

At least glance at Chapter 5 (“What to Do If You’re Injured”) to make certain that you have done everything you should following your injury. Feel free to turn to relevant chapters as the need arises and to skip any chapters that do not apply to your situation. For example, if the employer’s workers’ compensation insurance company has already accepted your case and begun providing benefits, you may want to skip Chapter 3 (“Is Your Injury Covered by Workers’ Compensation?”). Likewise, if the insurance company has proposed a settlement, you’ll want to turn to Chapter 19 (“Figure Out a Starting Settlement Amount”).

While great care has been taken to provide you with a comprehensive and informative book on your workers’ compensation benefits, this book cannot cover each and every aspect of workers’ compensation law in detail. Particularly if your claim has been denied or delayed, you’ll need to go beyond this book. (See Chapters 26 and 27 on hiring a lawyer and doing your own legal research.)

E. What This Book Does Not Cover

Workers’ compensation laws have changed tremendously over the last ten years. This has inevitably resulted in uncertainty, as different laws will apply to you depending on when you were injured (primarily, whether your injury took place before 2004, from 2005 through 2012, or in 2013 or later). Many of the new or revised laws are subject to interpretation and will continue to be interpreted for many years to come as workers’ compensation cases are brought to trial and legal decisions are appealed.

While I have given my best effort to provide you with accurate explanations of the law, this book is not a legal opinion on any issue or law and should not be relied on as such. If you have questions or concerns regarding a workers’ compensation issue or law, you should attempt to consult with a workers’ compensation attorney or get help from an information and assistance officer. A list of offices is provided on Nolo’s website (see Chapter 29, “Online Appendixes and Forms,” for the link to Appendix 1: “Workers’ Compensation Office Addresses and Code Lists”) or do your own research.

If you face any of the following issues, you should seek help beyond the book:

You were injured before January 1, 1994. For assistance, see an information and assistance officer or a workers’ compensation attorney.

Your employer was not insured. By law, your employer must carry workers’ compensation insurance or be permissibly self-insured. If, however, your employer does not have workers’ compensation insurance, you’ll probably need to seek compensation from the Uninsured Employers Benefits Trust Fund, discussed in Chapter 16, Section B.

An injured worker died. If an employee’s death was due to a work injury, at least in part, the worker’s dependents may file a claim for death benefits. The worker’s estate may be entitled to any accrued workers’ compensation benefits as of the date of death. (See Chapter 15 for more information.) If you feel the death was due to the work injury and the insurance company denies coverage, seek help from an information and assistance officer or see a lawyer.

You have a stress-related (psychological) injury. Insurance companies almost always deny these claims and will fight you every step of the way. If at all possible, find a workers’ compensation attorney to represent you or seek help from an information and assistance officer. (See Chapter 3, Section B7, for more information.)

If the statute of limitations has run. If the insurance company has denied your claim because it asserts that you failed to file your claim in a timely manner, you’ll need help beyond the book. Contact an information and assistance officer or see a lawyer. (See Chapter 5, Section C1, for more information.)

Posttermination claim. Sometimes an insurance company will deny a claim if you were terminated or laid off. If this happens, seek help from an information and assistance officer or see a lawyer.

This Book Comes With a Website

Nolo’s award-winning website has a page dedicated just to this book, where you can:

DOWNLOAD Appendixes - All Appendixes and forms in this book are accessible online. After purchase, you can find a link to the URL in Chapter 29.

KEEP UP TO DATE - When there are important changes to the information in this book, we will post updates

And that’s not all. Nolo.com contains thousands of articles on everyday legal and business issues, plus a plain-English law dictionary, all written by Nolo experts and available for free. You’ll also find more useful books, software, online services, and downloadable forms.

Customers Who Bought This Item Also Bought