After You Get Hurt on the Job

After You Get Hurt on the Job

  • Report the injury to your employer  
    Tell your supervisor right away. If your injury or illness developed gradually (like tendinitis or hearing loss), report it as soon as you learn it was caused by your job. Reporting promptly helps prevent problems and delays in receiving benefits, including medical care you may need to avoid further delay.
  • Report the injury to your union
  • Get emergency treatment if needed
    If it’s a medical emergency, go to an emergency room right away. Your employer may tell you where to go for treatment. Tell the health care provider who treats you that your injury or illness is job-related.
  • Fill out a claim form and give it to your employer
    Your employer must give you a claim form within one working day after learning about your injury or illness. You use it to request workers’ compensation benefits.
    Fill out and sign the "employee" portion of the claim form. Describe your injury completely. Include every part of your body affected by the injury. Give the form to your employer, which is called filing the claim form. Do this right away to avoid possible problems with your claim.
  • Get good medical care
    Get good medical care to help you recover. You should be treated by a doctor who understands your particular type of injury or illness. Tell the doctor about your symptoms and the events at work that you believe caused them. Also describe your job and your work environment.

Questions and Answers

  1. What happens after I file the claim form?
  2. Can I choose the doctor who will treat me for my job injury?
  3. I don’t like the medical care I’m getting. Is there any way I can switch to a different doctor in the first 30 days?
  4. The claims administrator hasn’t accepted or denied my claim yet, but I need medical care for my injury now. What can I do?
  5. Who decides what type of work I can do while recovering?
  6. It’s been more than 90 days since I filed a claim form, and I have not heard from the claims administrator. Does this mean my claim is accepted?
  7. Besides workers’ compensation benefits, can I get any other financial assistance?
  8. I filed a claim and I’m afraid I might be fired. Can my employer fire me?

Q. What happens after I file the claim form?

A. Your employer must fill out and sign the "employer" portion of the form and give the completed form to a claims administrator. (This person handles claims for your employer and usually works for your employer’s insurance company.)

Your employer must give you a copy of the completed form within one working day after you filed it. Keep this copy.

The claims administrator usually must decide within 90 days whether to accept or deny your claim.

Accepting the claim means the claim administrator agrees your injury is covered by workers’ compensation. If your claim is accepted, you will receive paid medical care for your injury. You may also be eligible for payments to help make up for lost wages.

Denying the claim means the claims administrator believes your injury is not covered by workers’ compensation. If the claims administrator sends you a letter denying your claim, you have a right to challenge the decision. Don’t delay, because there are deadlines for filing the necessary papers.

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Q. Can I choose the doctor who will treat me for my job injury?

A. It depends on whether you predesignated your personal physician. This means that before you were injured, you gave your employer the name and address of your personal physician in writing.

If you predesignated: You may see your personal physician for treatment right after you are injured, and you may switch doctors later if necessary. If you gave your employer the name of your personal chiropractor in writing before you were injured, you may switch to your chiropractor upon request.

If you didn’t predesignate: The claims administrator is usually allowed to choose the doctor who treats you during the first 30 days after your employer learns about your injury or illness.

After 30 days, you are allowed to switch to a doctor of your choice if you still need medical care.

Some employers have contracts with state-certified health care organizations (HCOs) to treat workers hurt on the job. If your employer has this kind of contract, there are different rules on choosing medical care. Your employer must give you written information about those rules.

Switching to another treating doctor: In some situations (as explained above), you have a right to switch doctors. The rules on who can treat you depends on your date of injury and the type of injury you have. For example, the new treating doctor can be a medical doctor, osteopath, psychologist, acupuncturist, optometrist, dentist, podiatrist, or chiropractor.

You or your new treating doctor must five the claims administrator the doctor’s name and address. This allows the claims administrator to obtain medical reports and pay for your medical care. You may switch again if necessary.

return to Questions

Q. I don’t like the medical care I’m getting. Is there any way I can switch to a different doctor in the first 30 days?

A. If you did not predesignate, speak with your employer or the claims administrator and see if they will agree to a new doctor of your choice. If agreement is not possible, you still have a right to change doctors one time during the first 30 days. Usually the claims administrator is allowed to choose the new doctor.

Sometimes employers lose the right to choose who will treat an injured worker, even if the worker did not predesignate. You can see a doctor of your choice in the first 30 days if your employer:

  • Didn’t post required information about your workers’ compensation rights; or
  • Didn’t tell you about your right to predesignate your personal physician; or
  • Sends you to treatment that is completely inadequate; or
  • Refuses to provide necessary medical care.

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Q. The claims administrator hasn’t accepted or denied my claim yet, but I need medical care for my injury now. What can I do?

A. Sometimes an employer will pay for medical care even before a claim is accepted. Ask your supervisor or someone else in management whether your employer will pay for medical care.

If you employer won’t pay, use your own health insurance to get medical care. You health insurer will be paid later if your injury is covered by workers’ compensation.

If you don’t have health insurance, try to find a doctor, clinic, or hospital that will treat you without immediate payment. They will be paid later if your injury is covered by workers’ compensation.

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Q. Who decides what type of work I can do while recovering?

A. Your treating doctor is responsible for telling your employer:

  • What kind of work you can can’t do while recovering
  • What changes are needed in your work schedule or assignments.

You, your treating doctor, and your employer should review your job description and discuss the changes needed in your job. For example, your employer might give you a reduced work schedule or have someone else do heavy lifting.

If you disagree with your treating doctor, you must promptly write to the claims administrator about the disagreement or you may lose important rights.

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Q. It’s been more than 90 days since I filed a claim form, and I have not heard from the claims administrator. Does this mean my claim is accepted?

A. If the claims administrator doesn’t send you a letter denying your claim within 90 days after you filed the form, your claim is considered accepted in most cases.

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Q. Besides workers’ compensation benefits, can I get any other financial assistance?

A. Other benefits may be available. These include:

  • Benefits paid by state and federal governments, such as State Disability Insurance (SDI), unemployment insurance, and Social Security Disability Insurance (SSDI) payments.
  • Benefits offered by employers and unions, such as sick leave, group health insurance, long term disability insurance (LTD), and salary continuation plans.
  • Payments if your injury was caused by someone other than your employer.

return to Questions

Q. I filed a claim and I’m afraid I might be fired. Can my employer fire me?

A. It’s illegal for your employer to punish or fire you for having a job injury, or for filing a workers’ compensation claim when hurt on the job. The California Labor Code (section 132a) prohibits this kind of discrimination.

It’s also illegal for your employer to discriminate against you because of a serious disability. The federal Americans With Disabilities Act (ADA) and the California Fair Employment and Housing Act (FEHA) prohibits this.

The federal Family and Medical Leave Act (FMLA) says that an employer with 50 or more employees usually must let you take unpaid leave for 12 weeks if you need time off for a serious medical condition.

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