What is Worker’s Compensation
Your employer is required by law to pay for workers’ compensation benefits which is to be used in the event of a work-related injury or illness.
Worker’s Compensation covers injuries that occur due to an accident or physical damage caused by repeated exposure to an unhealthy environment. Accidental injuries are different than those caused by exposure.
Accidental and Exposure Injuries
Some examples for accidental injuries on the job:
- Having a hand cut or crushed by machinery
- Falling off a ladder and hurting your back
- Being involved in a car accident and injured while making deliveries
- Chemical burns caused by a leaking canister
Repeated exposure to an unhealthy environment or repetitive motion is another way you could be injured at work.
Examples for repeated exposure injuries:
- Developing Carpal Tunnel Syndrome in your wrist from doing the same motion over and over
- Loss of hearing due to constant loud noise in workplace
It’s important to understand the help and benefits provided by Worker’s Compensation if you are injured.
Worker’s Compensation provides aid with medical bills, physical therapy, visiting nurses and medical supplies. Your benefits may also cover non-medical assistance from a Home Care Agency to help with bathing, after surgery care, housecleaning, transportation to doctor’s appointments and other daily chores.
If you fall and have spinal damage, you may require surgery, be unable to shower or dress yourself and even be confined to a wheelchair. Worker’s Comp would help with medical bills and supplies – including the wheelchair and cover some of the cost of medical bills, physical therapy and visiting nurses.
If your benefits include non-medical home care, you can also have help from a caregiver to take care of shopping, cooking, cleaning, laundry and your personal hygiene.
If your arm and shoulder were crushed by machinery, you would need several surgeries and have pain issues, restricted mobility and limits on caring for yourself. Having Worker’s Comp coverage guarantees you receive the medical care you need and can include a caregiver to assist you during recovery. Home Care Agencies will have caregivers knowledgeable with after surgery care to help speed your recovery.
If you suffer brain trauma, Worker’s Comp would provide the medical care and therapy you need during the process of surgery and physical therapy. With Traumatic Brain Injury, you could suffer long term memory or brain impairment and need a personal care attendant from a home care agency to assist you with bathing, dressing, daily chores and memory care.
What Do I Do if I’m Injured On the Job?
You must report the injury to your employer immediately. If your injury or illness developed over time, like Carpal Tunnel Syndrome, report it as soon as you determine it was caused by your job.
There can be delays in receiving benefits, including needed medical care if you fail to report the injury promptly.
You could lose your right to receive workers’ compensation benefits if your employer isn’t able to review the situation and your claim because you delayed in reporting it. Your employer must learn about your injury within 30 days and fully investigate the injury and how you were injured.
Get Emergency Treatment
If injured, do not refuse the medical help you need. Your employer may instruct you where to go for treatment. By law, he can’t tell you not to get emergency treatment.
Tell the health care provider or emergency room who treats you that your injury or illness is job-related.
Do I Need to Fill Out The Claim Form (DWC 1) My Employer Gave Me?
Yes. Giving the completed form to your employer starts the process of finding the benefits you may qualify for under state law.
You should receive a claim form from your employer within one working day after being notified about your injury or illness. If your employer doesn’t give you the claim form, you can also download it from the forms page of the DWC website.
Benefits may include, but are not limited to:
- A presumption that your injury or illness was caused by work if your claim is not accepted or denied within 90 days of giving the completed claim form to your employer
- Up to $10,000 in treatment under medical treatment guidelines while the claims administrator considers your claim
- An increase in your disability payments if they’re late
- A way to resolve any disagreements between you and the claims administrator over whether your injury or illness happened on the job, the medical treatment you receive and whether you will receive permanent disability benefits.
For more information, click here: http://www.dir.ca.gov/dwc/InjuredWorker.htm
What Benefits Am I Entitled To?
There are five basic benefits provided by Workers’ comp insurance:
- Medical care: This is paid by your employer to help you recover from an injury or illness caused by work
- Temporary disability benefits: You receive payments if you lose wages because your injury prevents you from doing your usual job while recovering. This is a percentage of your earnings.
- Permanent disability benefits: If you don’t recover completely, you’ll receive disability payments.
- Supplemental job displacement benefits (if your date of injury is in 2004 or later): If you don’t recover completely and don’t return to work for your employer, you may be issued Vouchers to help pay for retraining or skill enhancement to get another job.
- Death benefits: If you die from a job injury or illness, payments will be made to your spouse, children or other dependents.
What If I Have Other Questions?
A great resource is your local I&A officers (Information and Assistance Officers) and their services are free. They will provide the information you need to best help yourself.
There are free seminars for injured workers, through Local DWC district offices. These seminars provide full explanation of workers’ comp benefits, your rights and responsibilities. You can also arrange a private consultation at your convenience by making an appointment with an I&A officer.
Are Independent Contractors Covered Under Worker’s Compensation?
My Visiting Nurse Can’t Help with Daily Chores
Visiting nurses can assist with wound care, bathing, monitoring your healing process and other minor medical concerns and are arranged by your doctor. But there are many tasks you may need help with that she isn’t able to do.
A visiting nurse is responsible for many patients per day and can only provide in home medical assistance. She can’t provide help with house cleaning, laundry, preparing meals, shopping or drive you to doctor’s appointments.
If your Worker’s Comp benefits include Non-Medical Home Care Services, approved agencies can provide caregivers, nurse aides, home health aides or personal care attendants to help you with those everyday tasks that your injuries and pain prevent you from doing. These tasks are called Activities of Daily Living (ADLs).
HMOs, PPOs, Medicare or Medicaid won’t cover the services provided by Home Care Agencies since they are non-medical. The additional help provided by a Home Care Agency can help speed your recovery but you must verify it’s covered in your benefits.
A-1 Home Care Agency is State licensed, bonded and insured with care providers experienced in After Surgery Care. We have been helping injured, ill and senior residents of Los Angeles County, San Gabriel Valley and Orange County for more than 27 years.
If you are receiving Worker’s Comp Benefits, ask your lawyer or representative if you can use our home care services during your recovery.