California Workers' Compensation Claims FAQs
There is a great deal of misinformation about the California workers' compensation system, especially after the recent changes to the workers' comp law. At the Boccardo Law Firm in San Jose, our attorneys are frequently asked the following questions. We provide these answers in an attempt to help you make well-informed decisions about your workers' compensation claim. To discuss specific questions about your case, please contact our law firm for a free consultation.
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Q. Is my job covered by workers' compensation?
A. Yes. California requires all employers to provide workers' compensation insurance even if they only have one employee.
Q. What if the accident was partly my fault?
A. Workers' compensation was the first "no fault" insurance in the U.S. You do not have to prove fault or negligence. If you were injured as part of your job duties, you are entitled to workers' compensation benefits, even if you were partly at fault.
Q. Can I see my own doctor?
A. You must see a doctor approved by your employer for at least the first 30 days of treatment. After that you may be able to see your own doctor, but only if 1) You have group health insurance through your employer for non-work-related medical care; and 2) You notified your employer in writing before the date of your accident that you want your personal physician to treat you in the event of a work-related injury.
Q. Why can't I sue my employer?
A. In exchange for workers' compensation benefits, employees give up the right to sue their employer for on-the-job accidents and injuries. If a person or organization other than your employer contributed to your injury, you may recover damages through a third party claim.
Q. Can I get a lump sum payment instead of weekly benefits?
A. Yes, in some instances. After you receive a permanent disability rating, we can negotiate a settlement that includes a lump sum payment or weekly payments plus continuing medical care.
Q. How do the recent changes to workers' compensation law affect me?
A. In general, the changes make the role of the doctor much more important. The treating physician will determine, to a greater extent, whether or not you are ready to go back to work and the seriousness of any permanent disability. Benefits are now contingent on a utilization review. The doctor's treatment plan must be submitted for review for approval of a claims administrator.
Q. What happens if my claim or my treatment plan is denied?
A. You have an opportunity to challenge these denials through the appeals process. Our workers' compensation lawyer will request a hearing before a judge and present documents and information to show why the denial was an error.
For further information, please visit the practice area pages noted below and read the general information on our workers' compensation claims information center.
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