Process of filing a claim

1. Fill out claim form and give it to your employer. Your employer must give you a Worker’s Compensation Form (DWC-1) within one working day after you report your injury or illness. You use this form to request workers compensation benefits. If your employer does not give you a claim form, you can get it from a state Information and Assistance Officer or lawyer can get one for you. When filling out the form, be sure to describe your injury completely. Include every part of your body affected by the injury. Give the form to your employer. This is called “filing” the claim form. Do this right away to avoid possible problems with obtaining your benefits.

2. After the claim is filed, 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 workers’ compensation claims for your employer. Your employer must give or mail you a copy of the completed form within one working day after you filed it. Keep this copy. The claims administrator must decide within a reasonable time whether to accept or deny your claim.

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

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

 

Related Topics:

• California Employees Rights

• California Laws

• Benefits (Compensation)

• Predesignating a Physician

• Filing a Claim

• Resolving Disputes

• Workers’ Compensation Facts

• California Workers Comp FAQs