Frequently Asked Questions About California Workers’ Compensation

Workers’ compensation covers most injuries that arise during the course and scope of your employment. In other words, if you’re injured while completing an authorized work task, the injury is probably covered.

On the other hand, if you’re injured while doing something outside the scope of your employment (for example, driving home for lunch), the injury is probably not covered.

There are 2 basic types of covered injuries:

• A traumatic work event. Some injuries are the result of a single event—for example, a roofer who falls from a roof and hurts his back, or an oil worker who’s burned in an oil tank fire.
• Repeated exposures at work. Some injuries are the result of repeated exposure, such as a secretary who develops carpal tunnel syndrome from repetitive typing, or a construction worker who develops cancer as a result of working with asbestos for decades. 

Workers’ compensation covers some psychological injuries. The law is still developing in this area, but in all psychological-injury cases, an employee must at least show that work was the “predominant” cause of the injury. In other words, if you claim that a traumatic work incident contributed to your depression, you must prove that the event was at least 51% responsible for your depression in order to receive workers’ compensation benefits.

The statute of limitations for filing a workers’ compensation claim in California is 1 year from the date of the job-related injury.

However, it’s important to keep in mind that other deadlines must also be met if you want to avoid having your workers’ compensation claim denied. For example, California law requires that you report your work-related injury to your supervisor or some other person in management within 30 days from the date of the injury.

If you’re injured in a work-related accident in California, the following benefits may be available:

• Medical costs. Covered medical costs include doctor visits, tests, medicines, and physical rehabilitation, among other things.
• Temporary disability benefits. If your injury prevents you from doing your usual job while recovering, you can receive financial compensation.
• Permanent disability benefits. If you won’t recover completely, no matter how much treatment you receive, you can receive financial compensation.
• Supplemental job displacement benefits. You can receive a voucher to help pay for retraining or skill enhancement if you’re eligible to receive permanent disability benefits, your employer doesn’t offer you work, and you don’t return to work for your employer.
• Death benefits. Dependents of a worker killed as a result of an on-the-job injury can receive death benefits, including weekly financial compensation and money for funeral expenses.

Workers who “predesignate” their physician by informing their employer through a written statement or using DWC Form 9783 can use the doctor they select. However, this must be done before the worker suffers the work-related injury.   

If a worker doesn’t predesignate a physician, the worker’s employer is allowed to choose the doctor.

Workers’ compensation in California is a no-fault insurance system. This means you can recover workers’ compensation benefits even if your employer wasn’t responsible for your injury. There’s only 1 exception to this rule. If you intentionally cause your injury, you can’t recover workers’ compensation benefits.

If you disagree with the decision reached concerning your workers’ compensation claim, you can file a notice of appeal. This notice must be filed within 20 days of the service date of the decision (this date can be found in the lower right-hand corner of the determination letter).

All California employers that employ at least 1 person must carry workers’ compensation. Workers’ compensation insurance must be purchased from a licensed insurance company or through the State Compensation Insurance Fund.

As an alternative to obtaining workers’ compensation insurance from a licensed insurance company or through the State Compensation Insurance Fund, some employers have the option to self-insure (i.e., assume the financial risk for providing workers’ compensation benefits to employees).

Employers who wish to self-insure must meet the following conditions:

• The employer must first receive state approval
• The employer must have a net worth of at least $5 million
• The employer must have a net income of at least $500,000 per year
• The employer must post a security deposit

You must post the Notice to Employees poster in an open and obvious place at your work site. This notice provides employees with information on your workers' compensation coverage, as well as information on where to get medical care for work injuries.

Failure to post this notice is a misdemeanor that can result in a penalty of up to $7,000 per violation.

Additionally, all employers must provide newly-hired employees with a workers’ compensation pamphlet (also known as a “time-of-hire pamphlet”) explaining their rights and responsibilities.

There are a number of steps employers need to take when an employee is injured on the job:

• Make sure the employee has access to emergency medical care.
• Provide a Workers’ Compensation Claim Form (DWC 1) to the injured employee within 1 day of learning of their injury.
• Once the employee returns the form with the “employee” section filled out, fill out the “employer” section and give the form to the claims administrator and a copy of the form to the employee.
• Within 1 day of receiving the employee’s filled-out form, authorize up to $10,000 for appropriate medical treatment.
• Provide transitional work (light duty) whenever appropriate.

Failing to carry workers' compensation insurance is a misdemeanor punishable by:

• A fine of at least $10,000, or
• Imprisonment in the county jail for up to 1 year, or
• Both

Additionally, if an employee gets hurt or sick because of work and you’re not insured, you’re responsible for paying all bills related to the injury or illness.

It’s illegal for an employer to fire or otherwise punish an employee for filing a workers’ compensation claim. What’s more, it’s illegal to file or punish co-workers who testify on behalf of the injured employee.