Nelly Sang is our workers’ comp attorney at Mapes Legal, P.C. and she’s taken the time to answer one of the most common questions she hears from clients, “I've been injured at my job. What do I do now?” Below is Nelly’s advice on how to navigate an injury sustained while on the job and your best course of action moving forward.
If you need emergency medical treatment, go to the hospital right away.
Your health is your number one priority. If you are injured on the job and think that you have a serious condition, do not wait to go to the hospital. You do not need special permission from your employer or the insurance carrier to go to the hospital for a serious medical condition.
What if there is an onsite or on-call nurse who says you don't need to see a doctor?
If you think you need to see a doctor and/or disagree with the onsite nurse's “diagnosis,” you have a right to go see a doctor.
Report your injury to your supervisor as soon as possible.
There are many considerations for reporting your work-related injury.
The main concern includes experiencing retaliation at work. This is a very fair concern. Not all employers treat their employees well when they incur work injuries. The disparate treatment of injured workers is often economically-driven, as they will now need to accommodate an employee who cannot work a full shift, who might need some modifications to their typical job duties, or who simply needs time off work for recovery.
Other times, the employer's negative treatment comes from their misunderstanding of the diagnosis or the law. For instance, they might not realize that an injury is work-related if your job contributed at least 1% of the underlying medical condition. So, for instance, if you injured your back two years ago at the gym but feel that your back has been getting worse from lifting boxes every day at work, the employer can still be liable for providing you with workers' compensation benefits. Employers do not always understand this.
Fortunately, California law provides some protections for employees in reporting their injuries. For instance, California labor laws prohibit employers from discriminating against employees for the sole reason of a work-related injury. If you were fired or even threatened because of your injury, the employer would be liable for certain civil penalties.
If you are afraid of retaliation, it may be beneficial to consult an attorney to go over your options. However, the bottom line is that you need to recover from your medical condition. Waiting to get treatment or continuing to work through injuries can seriously exacerbate them. This can be the case, for instance, with frozen shoulder (adhesive capsulitis). Getting in for treatment right away can mean the difference between being out of work for a few months versus a few years.
Fill out the claim form.
After reporting your injury to your employer, they are obligated to provide you with a one-page claim form within 24 hours. You can also access the claim form off the state website here: https://www.dir.ca.gov/dwc/DWCForm1.pdf
Filling out and delivering the claim form is what triggers your right to obtain workers' compensation benefits. Sometimes the employer will help you with filling it out. This is ok so long as it is accurate. If the employer refuses to provide you with a claim form, we advise you to seek the help of an attorney immediately.
What happens after reporting the injury?
After reporting the injury, what happens next depends on whether the employer or their insurance carrier accepts, denies, or delays your claim.
If they accept your claim, you are simply entitled to workers' compensation benefits to the full extent the law allows. This includes access to medical treatment. However, medical treatment must be authorized by the insurance carrier, and it must be reasonably related to your industrial injury. The employer or insurance carrier's interpretation of “authorized” or “reasonably related” is where we often find litigable problems.
In any event, the employer and their insurance carrier must provide you with immediate and meaningful care. Hopefully, you will be able to get in to see a doctor swiftly, who will then determine what further medical treatment and any work restrictions you need.
If you are experiencing delays in obtaining authorization to see a treating physician or specialist, or if you disagree with your doctor's recommendations, those are litigable issues. We recommend you seek the help of an attorney to address those issues.
If the employer or carrier denies your workers' compensation claim, we recommend you call an attorney right away to discuss your options from there. Options include contesting the denial with the Workers' Compensation Appeals Board, getting treatment through your private physician, and getting unemployment disability benefits through the Employment Development Department.
If your case is on delay, this means the insurance carrier is taking 90 days to investigate your claim and make a determination whether your medical condition is work-related. During the delay period, you are still entitled to receive medical treatment paid for by the workers' compensation carrier. However, you may have the right to contest the delay or any doctor's determinations made in the meantime, for which we recommend you consult a workers’ comp attorney in Nevada County.
If you have any questions regarding your case or anything written in this article, we invite you to give us a call at (530) 426-2868. Consultations are free and designed to give you direction so that you can make an informed choice to do what's best for you and your family.