California Workers’ Compensation Basics
All California employers must have workers’ compensation insurance to provide workers’ compensation benefits to employees who have employment-related injuries and illnesses. The insurance company will pay for the employee’s medical treatment, lost wages and at times, compensation for a permanent impairment and job retraining caused by a work-related accident or illness due to conditions of the job. These can include a one-time accident, cumulative injuries (injuries caused by doing the same motion over and over), and illnesses arising out of the job environment or work tasks. In most instances, the injured employee receives insurance benefits, no matter who was at fault. Compensation may be denied if the employee was violating company policy or a law, or the injuries were self-inflicted or if the employee was not on the job at the time of the injury.
How to File?
An employer should be notified as soon as an injury occurs or a work-related illness has developed unless there is a medical emergency. In the case of a medical emergency, medical treatment should be sought first. An injury needs to be reported within 30 days or you may lose your right to collect benefits.
After treatment has been obtained, a DWC (Division of Workers’ Compensation) Form 1 should be completed and given to the employer, who will in turn give it to their workers’ compensation insurance company. An Application for Adjudication of Claim also needs to be filed within one year of the injury to officially file the worker’s comp claim. There are other forms that need to be filed as well. More information on how to file a claim can be found here.
Federal Workers’ Compensation Act (FECA) Basics
Am I Eligible?
All federal government employees are covered under FECA regardless of the time of service or type of work performed and only if they are employed by the federal government such as the post office, not a private government contractor. A private company will follow the state’s workers’ compensation program. Federal workers’ compensation may be denied if the injury was caused by intoxication or under the influence of a non-prescription drug, if there was intent to harm others or if there was willful misconduct.
An injury or illness that is covered by FECA must occur while performing work-related duties or a disease that arose due to working conditions. This can include injuries occurring while traveling or working offsite. FECA does not cover injuries and diseases that arise as a result of activities outside the course and scope of your employment. Activities outside employment include commuting to and from work, recreational outings, and activities for personal reasons. FECA also provides benefits to surviving family members for workers that die on the job while doing work-related activities.
Do I Need an Attorney?
If your FECA workers’ compensation claim is denied, your claim is complex, or your injury was serious, you should consider talking to an attorney who is experienced in FECA workers’ compensation law. Although an attorney is not necessary to obtain workers’ compensation benefits, an attorney can be helpful in guiding through the process and ensuring all of the benefits are received.
Please contact the Santa Barbara County Bar Association Lawyer Referral Service to find a lawyer to help – (805) -569-9400.