After your injury is reported, your employer has one day to issue you a workers’ compensation claim form, which is also known as Form DWC-1. At that time, your employer should also provide you with information about your right to workers’ compensation benefits and provide details as to the process.

If your employer has not done this within 24 hours of the incident report, you should consult a workers’ compensation attorney. The form can also be found on the forms page of the California Workers’ Compensation website.

Once you have filled out the form completely, return it to your employer and have them fill out the employer section. Once that is done, they have to turn the form into their insurance company and provide you with a copy. Make sure you don’t throw this copy out.

Insurance Company Decision

Authorization of your benefits can only come from your employer’s insurance company. They will do their own investigation into the matter and render a decision as to whether your injury or illness constitutes workers’ compensation.

Up until a decision is made, the insurance company is responsible for covering up to $10,000 in medical bills for you. They have 90 days to deny a claim. If, after that time, no denial has been made, it is considered approved.

Temporary disability benefits should be received within 14 days after being reported to the insurance company. If two weeks have passed with no word from the insurance company and no money, it is time to lawyer up because the insurance company owes you a late fee of an additional 10%.

Dealing with Denial

If the insurance company rejects your claim, all is not lost. You can still fight back for your right to be compensated.

To resolve a dispute with your claim, you have to open a case with the Workers’ Compensation Appeals Board. You can begin this process by filling out an Application for Adjudication of Claim. This must be done within one year of the date of injury, the last day your employer was providing medical benefits, or the last day of your temporary disability benefits.

Hire a California Workers’ Compensation Attorney

A skilled and experienced California Workers’ Compensation attorney is vital to fighting back against an insurance denial. California Workers’ Compensation law is complicated and messy. You need an experienced hand at the wheel.

Donald S. Fair, Attorney At Law has been fighting for workers’ compensation benefits since 1991. If you feel that your employer or insurance company is unfairly trying to impede your right to workers’ compensation, call Donald S. Fair at 909-344-3003, or fill out the contact form to book a free consultation.