I Was Injured at Work! What Do I Do Next?
When you suffer a work-related injury, it can be hard to know who to trust and what to do next. Keep in mind that your supervisor and co-workers may have your employer’s interests in mind when offering you advice. Frequently, we see employers who discourage injured employees from seeking the treatment they need or collecting the financial benefits they deserve through the workers’ compensation system.
The State of California requires your employer to ensure that your workplace is safe and healthy. Every employer is also required to have workers’ compensation insurance to cover injury claims arising out of job-related duties. The State requires this insurance because even when every precaution is taken, accidents and injuries still happen. The State has also set up a special system for handling these claim that allows injured workers to avoid the expensive and time-consuming process of filing a law suit in civil court.
Here are the first steps to take in order to access the workers’ compensation system:
1. Report your injury to your supervisor immediately
2. Request a DWC-1 form to document the incident
3. Complete the DWC-1 and return it to your employer
4. Receive the DWC-1 from your employer with their portion completed
5. Receive an acknowledgement letter from your employer’s workers’ compensation insurance company
Let’s look at each step more closely.
Report Your Injury
There are two types of work-related injuries: specific and cumulative trauma. A specific injury is one that occurs at a specific day and time, for example a slip and fall or being hit by a falling box. A cumulative trauma injury is one that develops over time, often related to overuse, strains, or repetitive motion. An example of a cumulative trauma injury is a low back strain that develops over days of heavy lifting.
If you suffer a specific injury, you should report it immediately to your supervisor. Often, you may not know the extent of your injury until you wake up the next morning. In that case, report it to your supervisor as soon as you are aware of the injury.
If you suffer a cumulative trauma injury, report it as soon as you are aware that it is work-related. Often workers dismiss cumulative trauma injuries as ordinary aches and pains until they get so serious that they have to take time off of work or have to see a doctor. Once you or your doctor identifies the cause of the injury to be work-related, be sure to tell your supervisor.
Reporting your injury to your supervisor starts the clock for your employer’s duty to respond appropriately under California law. The law requires your employer to provide you with a claim form, titled a DWC-1, which is a standard form issued by the State to be filled out by the injured worker and the employer.
Request a DWC-1
If your employer doesn’t immediately provide one when you report your injury, you should request a DWC-1 from your supervisor. This form allows the injured worker to provide their personal contact information and the date and description of the injury. The form also allows the employer to provide its formal mailing address and workers’ compensation insurance information. Think of the DWC-1 as the workplace version of exchanging driver’s license information at the scene of a car accident. It allows both parties to have a record of the incident and the related contact information on one page.
If your employer refuses to provide a DWC-1 form to you, immediately contact an attorney to pursue your claim and to make sure your employer complies with California state law. You can contact us any time for a free consultation to discuss your claim.
Complete and Return the DWC-1
When you receive the DWC-1, fill in your personal information and your description of the injury. Be honest, but don’t worry about providing every last detail. This step is mainly to document when, where, and how the injury occurred. Much of this information will be added to or may even be changed later in the life of your claim. Once you have completed your portion of the form, return it to your supervisor or your employer’s Human Resources (HR) department. This starts the clock for your employer to complete its portion and return the completed DWC-1 to you within 24 hours.
Receive the Completed DWC-1
Within 24 hours, you should receive the completed DWC-1 form from your employer with its mailing contact information and workers’ compensation insurance information. If your employer does not return the DWC-1 form to you or does not have workers’ compensation insurance, immediately contact an attorney to pursue your claim and to make sure your employer complies with California state law. You can contact us any time for a free consultation to discuss your claim.
Your claim is not jeopardized by your employer’s failure to act or to carry the proper insurance. The workers’ compensation system in California is set up to allow you to continue to pursue your claim, get the treatment you need, and receive financial benefits you deserve whether or not your employer complies with their end of the requirements.
Receive the Acknowledgement Letter
After you and your employer complete the DWC-1, your employer has 24 hours to send the completed form to its workers’ compensation insurance carrier. That carrier will then open a claim in their system and send you a generic letter acknowledging that they have received notice of the claim. This letter is an important step because it provides you with the name and contact information for the claims adjuster who will be processing your claim.
The claims adjuster will be the person you interact with to move your claim forward, request medical treatment, and request financial benefits like temporary disability, permanent disability, and mileage reimbursements. Keep in mind that claims adjusters come from all walks of life. Some are kind and easy to work with, others will stall, delay, and hide the ball to frustrate you and make your claim more complicated than it needs to be.
This is one of the biggest reasons why injured workers hire attorneys. If you do not get along with the claims adjuster, feel like your getting false information, do not get timely responses, or your claim is being delayed, you should speak with an attorney who can level the playing field. As a former defense attorney who represented insurance companies, I have years of experience working with claims adjusters and can help you manage this relationship so that your claim runs smoothly and you can focus on recovering. Contact me for more information.
Receive an MPN Listing
Often your injury may have required emergency medical treatment and you may have been taken to the Emergency Room at the nearest hospital. If so, the ER doctors will provide the bare minimum of treatment before directing you to pursue the rest of your treatment through your employer’s workers’ compensation insurance provider.
If your injury did not require a visit to the ER, you will most likely still need to see a doctor. Visiting your personal doctor can be expensive. This cost should be covered by your employer’s workers’ compensation insurance provider.
If your employer’s insurance carrier has a Medical Provider Network (MPN), your employer or the insurance company should provide you with a list of doctors near your home where you are authorized to request treatment. Not every insurance carrier has an MPN. If your employer’s carrier does not have an MPN, you may be able to treat at any doctor.
Either way, with or without an MPN, you should consult a workers’ compensation attorney to help you in choosing the right doctor. Often the specialty and specific doctor you choose at this early stage will make a big difference in whether you receive the care you need to return to work and the financial benefits you deserve to compensate you for your injury and any lost time from work. You can contact us any time for a free consultation and to discuss your doctor selection.
Conclusion
Once you have completed the initial steps described above, your claim has begun. As you can see, the workers’ compensation system is often difficult to navigate and often requires the guidance of a skilled and experienced attorney. Otherwise, you can end up feeling like you are fighting an uphill battle where you are the only person who cares about your interests, health, and well-being. The good news is, you don’t have to do it alone. We are here to provide injured workers with solid advice every step of the way to ensure your medical needs are met, your financial needs are covered, and you can get back to work. Contact us today for more information.