If you have an injury or illness resulting from your employment, you may be entitled to workers' compensation benefits, provided for you at your employer's expense. The injury or illness may result from a single incident or from repeated or prolonged exposure to activities or substances at work. With only a few exceptions, all California employers are subject to State workers' compensation laws. More than four out of five workers receive workers' compensation benefits from insurance carriers who cover their employers' liability. The remainder receives benefits directly from employers who are self-insured. Federal employees and persons covered under federal legislation have other benefit programs and should contact the United States Department of Labor.

The law requires you to give "reasonable assistance" to injured persons. For example, you may need to call an ambulance, take the injured person to a doctor or hospital, or give first aid - if you know how. If you think you will get in trouble for being a good Samaritan, you are wrong. California law says that you are not "liable" or responsible if you act in a reasonable way.

You may be entitled to one or more of the following benefits depending upon your individual situation.

You will receive all medical treatment necessary to cure or relieve you from the effects of a work-caused injury or illness. This includes physician's services, hospitalization, physical restoration, dental care, and prescriptions. X-rays, laboratory studies and all other necessary and reasonable care ordered by your physician. There are no deductibles-the total cost of medical care is paid directly by the employer or its insurance carrier as a workers' compensation benefit. In workers' compensation law the term "physician" is defined to include physicians and surgeons, psychologists, optometrists, dentists, podiatrists, osteopathic, and chiropractic practitioners licensed by California State law.

If your physician confirms that you cannot work because of your work-caused injury or illness, you are eligible for disability benefits. You will not be paid for the first three full days off work after injury unless you are off more than 21 days or you are hospitalized overnight. Payments continue until your physician releases you to return to work or decides that your condition has reached a point of maximum improvement. The weekly rate for temporary disability payments is usually based on two-thirds of your gross weekly wages. For injuries on or after January 1,1984, the minimum paid is $112.00 per week and the maximum paid is $224.00 per week. These payments are based on a 7-day week, and one day's compensation is equal to one-seventh of the weekly rate.

If your physician allows you to return to part-time work or modified work while you are still recovering from your injury or illness, and if you are receiving less than your usual earnings, you may be entitled to temporary partial disability.

If your injury or illness results in a permanent impairment that reduces your ability to compete in the labor market, you may be entitled to permanent disability benefits. If you believe that this applies to you, you should first discuss the nature of your disability with your physician; and then your eligibility for permanent disability benefits with your employer or the insurance carrier. Permanent disability can be evaluated only after your physician determines that your condition has reached maximum improvement and further change is not likely. At that time your condition has become "permanent and stationary" and can be evaluated. Your employer or insurance carrier will send a request for a determination of the extent of permanent disability along with all of your doctor's reports to the disability evaluation bureau of the State Division of Industrial Accidents. A determination of how much permanent disability exists will be made and you will be advised of the amount of the benefit.

If you are not likely to be able to return to your usual job duties because of your injury, you may be entitled to rehabilitation benefits to assist you in returning to work. While you are enrolled in a rehabilitation plan approved by the State Division of Industrial Accidents Rehabilitation Bureau, the total cost of services and temporary disability is paid as part of your workers' compensation benefits.

You should be reimbursed by the insurance carrier or your self-insured employer for the reasonable costs of transportation to secure medical care and rehabilitation. We suggest you keep a record of the date and purpose of your trips, round trip mileage or public transportation costs, bridge tolls and parking costs, and send it to the insurance carrier or self-insured employer.

If the work-caused injury or illness results in death, benefits may be paid to qualified surviving dependents. The maximum death benefit is $150,000. There is a separate allowance for reimbursement of reasonable burial expenses up to $1,500.

If you believe you have suffered an industrial injury or illness, you should:

Report it immediately to your supervisor so that you can receive appropriate medical care and proper reports can be made.

Contact your doctor to find out if a report was sent to the workers' compensation insurance carrier or your self-insured employer.

You may be treated by your own doctor for injuries requiring more than first aid, if prior to your injury, you notified your employer in writing of the name of your personal physician who has previously treated you and who has your medical history and record.

If you have not given such notice prior to your injury, the employer is responsible for arranging medical treatment.

If after notification, or, in the case of an emergency, your employer fails to refer you to a doctor, you may choose your own doctor for treatment of your work-caused injury or illness.

If medical care is still required after thirty (30) days from the date your injury or illness is reported to your employer, you have the right to choose your own treating physician. You must promptly notify your insurance carrier or self-insured employer of the name and address of your newly selected physician, who must report within five (5) days to the insurance carrier or self-insured employer that medical care is being provided. Your employer also has the right to require that you be examined by a medical consultant of his choice, at their expense.

You are not responsible for the cost of medical treatment covered by workers' compensation. Bills for treatment are to be sent by the medical care provider directly to the insurance carrier, or employer if self-insured.

Any disputes concerning your workers' compensation benefits should be referred to the Workers' Compensation Appeals Board. If you believe a person other than your employer is responsible for your injury, you may be able to seek payment from that party in a civil court.

Workers' compensation and labor laws prohibit discrimination against: Workers who are injured because of their employment; Workers who testify or intend to testify before the Workers' Compensation Appeals Board regarding another employee's case.

In such cases, the worker may be entitled to reinstatement and reimbursement for lost wages and lost work benefits caused by the employer's action as well as an increase in workers' compensation benefits, as determined by the Workers' Compensation Appeals Board.

If you have questions about your claim, seek help immediately. Some questions may be answered promptly. Others may require more time to gather additional information from your employer or physician or rehabilitation counselor, before your question can be answered. The workers' compensation laws contain time limits or beginning proceedings. In general, the limitation is one year from the date of injury, although the time is extended medical or disability payments were provided because of your injury. It is very important that you act promptly, so that you do not risk loss of benefits because you waited too long.

Disclaimer: The purpose of this web site is to provide general information on an area of California law, which may differ from law of other states. It is not intended to give legal advice regarding any specific legal problem. Readers should know the law is complex and constantly changing. Therefore, anyone with a specific legal problem should consult an attorney.