The workers’ compensation claims process can be frustrating for many reasons, including the fact that it is partially dependent on your employer doing the right thing. When you want workers’ compensation benefits after a workplace accident, you have to tell your employer about your accident and injuries, so they can then tell their workers’ comp insurance provider, be it a private insurance company or the state-level workers’ compensation administration or agency. At this point is where many workers’ comp filings slow down because an employer doesn’t complete their responsibilities correctly.
California Workers’ Comp Reporting Time Limits
In California, you have 30 days to report a work-related injury to your employer. Waiting the full 30 days is not advised, though, because reporting it sooner means you can get medical attention and workers’ comp benefits sooner, too.
Once you report your injury to your employer, they have just one workday to give you a workers’ compensation claim form, which should be filled out and returned as soon as possible. When you return the completed form to your employer, they must give you a copy of that completed form within one workday – and they must forward a copy of your completed claims form to a claim administrator from the insurance party that will handle the claim. The insurance company then also only has one workday upon receiving the copy to authorize at least $10,000 in medical treatments for the injured claimant.
Under this system, you could have your first set of nonemergency medical treatments authorized within the first 72 hours of your workplace injury. For example, you slip-and-fall at work on Monday and tell your employer on the same day. They give you a workers’ comp claim form, which you fill out and return by the end of your shift on Monday. By Tuesday afternoon, your employer must return with a copy of your completed form and notification that they have forwarded it to the insurance adjuster. By Wednesday afternoon, the insurer must have approved or denied the claim.
How Do You Know If Your Employer Didn’t Report Your Claim?
Are you worried that your boss has forgotten to report your claim to the appropriate insurance company on time? Are you wondering how you can know for certain if they did or not? The easiest way to get verification is to ask your employer. You cannot be retaliated against for asking about the status of your workers’ compensation claim or benefits.
Fortunately, California’s quick response time requirements for workers’ comp claims should also mean you should not be left wondering for too long. Again, if you gave a completed workers’ comp claim form to your employer on Monday, then a response should be returned by the insurer no later than the end of Wednesday. If three or more days have passed with no word about your claim’s status, then something is wrong, and it might be that your employer forgot to forward your claim as instructed.
Why Would an Employer Not Report a Claim?
In most situations, an employer or supervisor might forget to report an employee’s injury out of forgetfulness. Store and office managers often have packed schedules, so forgetting one task in the day is possible. However, forgetting a task as important as forwarding an employee’s injury report to a workers’ comp insurer can create severe complications, so employers need to prioritize such tasks above most anything else.
Other less excusable reasons why an employer might not report your work injury claim are that they think:
- Your injuries are serious enough to validate workers’ comp benefits.
- Your accident is not covered by workers’ comp rules.
- Your claim will increase their workers’ comp premiums.
- You can use your own healthcare benefits to treat yourself instead.
- You will give up the claim entirely if they delay it long enough.
There is also the chance that your employer also does not have workers’ compensation insurance coverage to provide you. California requires all employers to have private or state-managed workers’ compensation coverage, even if the employer has only one employee on payroll, so not having it would not only be problematic but also illegal.
Talk to an Attorney with Any Concerns
If you are worried that your employer is not handling your workers’ compensation claim correctly, then you cannot exactly trust them to sort the problem out for you. Instead, you should turn to the assistance of a local workers’ compensation lawyer. With an attorney by your side and acting on your behalf, you can press your claim forward, insist that the case is handled correctly, challenge denials, and possibly even move to a lawsuit if your claim has been mishandled to the point that it interfered with your health and/or work.
The Law Offices of Wax & Wax offers comprehensive workers’ compensation legal services to claimants in Santa Clarita, California. Call (818) 946-0608 to see what our law firm can do for you. Every potential client qualifies for a free initial consultation with our attorneys.