Depending on the nature and severity of the injury, the short- and long-term consequences on work capacities, and how the employer and claims administrator respond to the claim, the workers' compensation process can look different for each person.

That said, let's look at the most common aspects of workers' comp, as they are often handled by our prescreened California Labor Law Attorneys.


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You may find that not all of the phases below apply to your situation, but understanding the process as a whole will help you prepare for any eventuality. Starting with the initial injury, here's what you may expect.


1. You Get Injured


This could be a one-time accident-related injury, an occupational disease, or a repetitive stress injury that develops over months or years of employment. You would have a case for workers' compensation if the injury occurred at work or as a result of your job.


If you require immediate medical attention due to an injury sustained at work, your employer should assist you in making the necessary arrangements.


2. Notify Your Employer And Fill Out Your Claims


You should notify your employer as quickly as possible after suffering or learning of a work-related injury. You should receive a Workers' Compensation Claim Form from your employer, which you must complete and return. The claims adjuster will then examine your claim at your place of business.


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3. Indicate Your Primary Physician


If you have identified a doctor or healthcare provider in writing with your employer before your injury, that doctor can treat your work-related injury as the primary treating physician.


Otherwise, you must select a physician from your company's medical provider network (MPN) or health care organization (HCO), or your employer may do so.


4. Get Immediate Medical Help


While reviewing your claim, the claims administrator should allow treatments in addition to emergency treatment.


When it comes to insurance claims, the most crucial thing is proof of your injuries and losses. Other than photos and eyewitness claims, getting it in medical records will help prove the extent (and the expenses) brought by your injuries.


These records can also be used by your California Employment Lawyer in building your claim.


5. Wait For The Final Decision On The Claim


After reviewing it, the administrator will decide whether to accept or refuse your claim. Workers' compensation benefits will cover any additional medical care if your claim is accepted.


If your claim is refused, it indicates the administrator believes you are ineligible for benefits. You must try to fix the issue or file an appeal.


6. Listen To Your Doctors


Once your claim has been approved, your primary treating physician will use medical guidelines to prescribe acceptable treatment to aid in your rehabilitation, with your employer covering the costs. Your doctor will also provide the claims administrator with updates on your capacity to return to work.


Our California Employment Law Attorneys advise that you collect all the receipts and prescriptions. These can also count as proof of your losses.


7. Assessment Of Disability Benefits


The claims administrator will determine whether you are qualified for temporary or permanent disability benefits that cover a portion of your lost wages based on your physician's reports.


If you are unable to work for more than three days, you may be eligible for temporary compensation.


On the other hand, permanent benefits can only be determined if your doctor certifies that you have obtained maximal medical improvement, which could take several weeks or longer.


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Bottom-line


Getting the compensation you deserve is crucial. But unfortunately, work-related injuries tend to keep you out of work, which means income loss.


If the insurance adjuster refuses to give you the compensation you deserve, or if your boss refuses to process your claim, then you should contact a California Employment Attorney to help you.


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