Filing a Workers' Compensation Claim in California

• The Workers' Compensation Appeals Board is the trial court for all industrial injuries involving your employer.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.
• The state worker's compensation act relates to agricultural workers. Domestic workers, containing child care help, who are employed 52 or more hours, or who earned $100 or more, during 90 calendar days immediately preceding the date of injury or last employment exposing the worker to the hazards of an occupational disease, are covered by the state worker's compensation act, with the exception of workers employed by a parent, spouse, or child.
• Attorneys' fees are set by the Workers' Compensation Appeals Board and are usually 12% to 15% of your award or settlement. Attorneys are also entitled to a similar fee for assisting in arranging the rehabilitation program. When there is no recovery on a case, there is no attorneys' fee.

California Waiting Period
The waiting period for comp benefits after the injury is 3 days (temporary total disability only.)Compensation is retroactive if disability continues 14 days from when the injury occurs. (Also retro- active if person is hospitalized)

Attorney Fees Permitted: Individual case basis; however an attorney cannot collect a fee for representation.

California Workers’ Compensation Treatment:
Sometimes the injured worker's attorney and the insurance company can agree to employ one doctor to examine the injured worker once he/she is enduring and stationary.
The consulting physician prepares a detailed narrative report setting forth his or her opinion as to the nature and extent of any disability, the need for further medical care and the ability to return to work. It usually takes the doctor about 4 to 6 weeks to prepare and mail out the report.

California Workers’ Compensation Benefits:
Full medical benefits are provided to employees entitled to worker's compensation benefits, with no time or monetary limits. Unless a personal physician has been pre-designated by the employee from an employer-sponsored health plan for medical conditions unrelated to work, the employer selects the initial physician who will provide care, with the employee obtaining free choice of provider usually after thirty days. However, if the employer has established a PPO-style network, the employee must choose a physician from within the network.

One benefit is that relying upon one doctor to address the issues eliminates the problem of trying to settle a case based upon two medical opinions that are often in major disagreement. Another good reason is that when using an AME, it is pretty much certain that the resolution of the case will be based upon the medical issues as opposed to legal technicalities.

Scheduled awards are paid in addition to total temporary disability benefits starting upon termination of the termination of the TTD benefits. Scheduled awards are not reduced because of receipt of TTD benefits.

Physical rehabilitation benefits are available, and limited vocational rehabilitation benefits may also be available to some injured workers.

California Workers' Compensation Contact Information:
Carrie Nevans, Administrative Director
Division of Workers’ Compensation
455 Golden Gate Avenue, 2nd Fl.
San Francisco, CA 94102-7014
(415) 703-5011 (415) 703-5011 or 1-800-736-7401 1-800-736-7401

NOTICE: These questions and answers concern California law only, and should not be construed nor relied upon as reflecting the law in other States, nor as giving legal advice. You are warned that circumstances often vary greatly and that, due to changing decisions and law, the answers to these questions may change over time and not be current, and you should consult an attorney in any specific case, and NOT rely on these questions and answers as giving anything other than general information.