Workers' Compensation in California: A Guide for Injured Workers

How Does Workers’ Comp Work in California?

Here’s how a typical California workers’ comp claim works, from the day you get hurt to the end of your case:

1. You get hurt or sick because of your job. It can be a sudden accident or an injury that builds up over time.
2. You report it to your employer in writing, within 30 days.
3. Your employer gives you a claim form (DWC-1) within one working day. You fill it out and turn it in.
4. You get medical care. The insurance company must pay for up to $10,000 in treatment while it decides your claim.
5. The insurance company accepts or denies your claim, usually within 90 days.
6. If it’s accepted, you get benefits, like medical care and temporary disability checks while you can’t work.
7. Your doctor decides when you’ve healed as much as you will. If you have lasting damage, you get a permanent disability rating.
8. Your case ends with a settlement or an award approved by a workers’ comp judge.

If the insurance company denies your claim or a benefit along the way, you can challenge it. Learn more about denied claims and the appeal process.

California Workers’ Compensation Laws Every Worker Should Know

California’s workers’ compensation laws give injured workers important rights. The most important ones are:

• It’s no-fault. You can get benefits even if the accident was your own mistake, with a few exceptions, like being drunk or hurting yourself on purpose.
• Almost every employer must have coverage. Any California employer with even one employee must carry workers’ comp insurance or be approved to self-insure.
• Your immigration status doesn’t matter. California workers’ comp covers all employees, no matter their status.
• You can’t be punished for filing. It’s illegal for your employer to fire, demote or threaten you because you got hurt or filed a claim. Learn about wrongful termination.
• Deadlines are strict. Report your injury within 30 days, and in most cases file your claim within one year.
• The 90-day rule. If the insurance company doesn’t deny your claim within 90 days of when you turned in your claim form, the law presumes it’s covered.
• Workers’ comp is usually your only claim against your employer. In most cases, you can’t sue your employer for a work injury. You may be able to sue someone else who caused it, like another driver or an equipment maker.
• A judge must approve any settlement. This protects you from signing away your rights without review.

Learn more about your rights as an injured worker.

Who Is Covered by Workers’ Comp in California?

Workers’ comp eligibility in California is broad. Almost every California employer with even one employee must carry workers’ compensation insurance, so most workers are covered from their very first day on the job.

Workers Who Are Usually Covered

• Full-time and part-time employees, no matter how few hours you work
• Temporary and staffing agency workers
• Seasonal workers, like farmworkers and holiday retail staff
• Undocumented workers. Your immigration status doesn’t affect your right to benefits.
• Public employees, like teachers, city and county workers, firefighters and police officers
• Workers paid in cash or by the job, if they’re employees under the law
• Many workers labeled “independent contractors”

Independent Contractors and the ABC Test

Being called an independent contractor, or getting a 1099 instead of a W-2, doesn’t automatically mean you’re not covered. California uses a three-part “ABC test” (from the law known as AB5). Under it, you’re treated as an employee unless your employer can prove you control how you do the work, your work is outside the company’s usual business, and you run your own independent business. Many workers who fail that test are employees with full workers’ comp rights.

What Kinds of Injuries Are Covered

To qualify for workers’ comp, your injury or illness must be caused by your job. That includes:

• Sudden injuries, like falls, cuts, burns and car crashes while driving for work
• Injuries that build up over time, like back damage, carpal tunnel or hearing loss. The law calls these cumulative trauma injuries.
• Occupational illnesses, like lung disease from dust or chemicals
• Mental health conditions caused by work, under stricter rules

Some public safety workers, like firefighters and police officers, get special rules called presumptions. For certain conditions, like some heart problems, cancers and PTSD, the law presumes the job caused them, which can make those claims easier to prove.

Who Usually Isn’t Covered

• True independent contractors who run their own businesses
• Most volunteers
• Some household workers, like a babysitter or housekeeper who works only a few hours
• App-based rideshare and delivery drivers, who are covered by different rules under Proposition 22
• Federal employees, like postal workers, who are covered by a separate federal workers’ comp system

Coverage questions can be complicated, and employers sometimes label workers wrong. Read do I qualify for workers’ comp to check your situation, or call us for a free review.

Workers’ Comp Benefits in California

If your claim is accepted, California workers’ comp can pay for:

See the full breakdown, with current amounts, on our California workers’ compensation benefits page.

How to File a Workers’ Comp Claim in California

Filing a workers’ comp claim in California isn’t complicated, but each step matters. Doing them right, and on time, protects your benefits.

Step 1: Get Medical Help

For an emergency, call 911 or go to the nearest ER. For anything less urgent, ask your employer where to get treatment. Many employers use an approved group of doctors or a specific clinic. If you told your employer in writing before you got hurt that you want your own doctor, you may be able to see that doctor instead. Either way, tell the doctor right away that you were hurt at work.

Step 2: Report Your Injury to Your Employer in Writing

Tell your supervisor or employer as soon as you can, and within 30 days. Telling someone out loud counts, but a written report is much stronger proof. Include:

• The date, time and place you got hurt
• What you were doing and what happened
• Every body part that hurts, even if it seems minor
• The names of anyone who saw it

Keep a copy, or send it by text or email so you have a record. If your injury built up over time, report it as soon as you realize your job caused it.

Step 3: Fill Out the DWC-1 Claim Form

Your employer must give you or mail you a DWC-1 claim form within one working day after you report the injury. Fill out the employee section completely, sign it and return it to your employer. Hand it in or send it in a way you can prove, and keep a copy.

If your employer won’t give you the form, you can download it from the California Division of Workers’ Compensation website.

Step 4: Know What Happens After You File

The date you turn in your claim form starts important clocks:

• Within one working day, your employer must send your form to its insurance company, give you a dated copy and authorize medical treatment.
• While your claim is being decided, the insurance company must pay for up to $10,000 in medical care.
• Within 90 days, the insurance company must accept or deny your claim. If it doesn’t deny it in time, the law presumes your injury is covered.

Watch your mail. The insurance company will send letters about your claim, your benefits and any delays. Keep every one.

Step 5: Tell Every Doctor It Was a Work Injury

At every appointment, say your injury happened at work and describe every symptom. Be honest and consistent. Don’t guess, exaggerate or leave things out, because the insurance company will compare your medical records. Follow your doctor’s work limits and keep your appointments, since gaps in treatment can hurt your claim.

Step 6: Keep Records of Everything

Keep a folder with your claim form, medical reports, prescriptions, letters from the insurance company, pay stubs, a log of mileage to medical visits, and witness names and phone numbers. A simple notebook of your symptoms and missed workdays helps too.

Deadlines to Remember

When to Call a Lawyer

Talk to a lawyer right away if your employer won’t give you a claim form, tries to talk you out of filing, tells you to use your own health insurance instead, or punishes you for getting hurt. You should also get help if your claim is denied, your checks are late or your treatment is refused.

Workers’ Comp Settlements in California

Most California workers’ comp cases end with a settlement or an award. A settlement usually comes after your doctor says you’ve healed as much as you’re going to, which is called being “permanent and stationary.” At that point, a doctor rates any lasting damage, and that rating becomes the starting point for what your claim is worth.

What Affects the Value of a Settlement

• Your permanent disability rating, based on the doctor’s report, your age and your job
• Your earnings before the injury
• The cost of future medical care, especially if a Compromise and Release would end it
• Unpaid temporary disability or penalties the insurance company owes you
• Disputes over the claim, like whether the injury happened at work

There’s no settlement chart in California. Two workers with the same injury can end up with very different amounts.

How a Settlement Gets Approved and Paid

1. You and the insurance company agree on the terms and sign the settlement papers.
2. A workers’ comp judge reviews the settlement to make sure it’s fair to you. No settlement is final without a judge’s approval.
3. Once it’s approved, a Compromise and Release is usually paid within about 30 days. A Stipulated Award is paid in installments.

Some amounts may come out of your settlement, like permanent disability advances you already received, an attorney’s fee approved by the judge, and certain liens, such as for state disability benefits paid while your claim was disputed.

Questions to Ask Before You Sign

• Is my disability rating correct, or could a second medical opinion change it?
• Am I giving up future medical care? If so, does the money cover what I’ll need?
• Am I owed any unpaid disability checks or penalties?
• What will come out of the settlement before I’m paid?
• If I’m on Medicare or expect to be, does the settlement account for that?

Once a judge approves a Compromise and Release, it’s very hard to undo. Talk to a lawyer before you sign anything. Learn more in I got hurt at work, will I get a settlement?

When Your Claim Is Denied or Disputed

Insurance companies sometimes deny claims, stop checks or refuse treatment. You have the right to fight back:

• Denied claim: read what to do if your workers’ comp claim is denied
• Denied treatment: ask for Independent Medical Review within 30 days
• Disagreement over a medical report: a neutral, state-certified doctor (QME) can weigh in
• Any other dispute: a workers’ comp judge can decide it. See the workers’ comp appeal process.

Workers We Represent

We help Southern California workers in every kind of job, including:

• Construction and industrial: construction workers, industrial workers, warehouse and delivery workers, automotive employees, and stone and countertop workers exposed to silica
• Healthcare and first responders: healthcare workers, hospital workers, nurses, EMTs and paramedics, firefighters and police officers
• Public and service jobs: teachers and school employees, postal and government workers, airline and airport employees, restaurant employees, grocery and market workers, and office and business professionals
• Union workers and non-union workers alike

Work Injuries and Accidents We Handle

• Injuries: back and neck injuries, concussions, severe burns, electrocution, broken bones, repetitive stress injuries, lung disease, mental health conditions and COVID-19. See all workplace injuries we handle.
• Accidents: falls, forklift accidents, crane accidents, scaffolding accidents, trench collapses, welding accidents, oilfield accidents, explosions and car accidents while working. See all work accidents we handle.

Southern California Workers’ Comp Lawyers Who Know the System

Workers’ comp in California is complicated, and the insurance company has its own adjusters and lawyers. At Rodich Law, you get lawyers who know how the insurance side works and how the judges who decide these cases think.

• Gary Rodich is a Certified Specialist in Workers’ Compensation Law, certified by the State Bar of California Board of Legal Specialization.
• He knows how insurance companies think. He spent the early part of his career working for insurance companies before switching sides to represent injured workers.
• He has served as a judge pro tem, so he knows how workers’ comp judges look at a case.
• We help with every part of your claim, from filing your claim form to fighting a denial, getting treatment approved, checking your disability rating and reviewing any settlement.

From our office in Woodland Hills, we represent injured workers throughout Southern California, including Los Angeles, Ventura, Orange, Riverside and San Bernardino counties. Learn more about our attorneys, see our case results and read client testimonials. Past results don’t guarantee the outcome of a new claim.

Not in Los Angeles? We also have local pages for injured workers across the region: a San Bernardino workers’ compensation lawyer for the Inland Empire, an Oxnard workers’ compensation attorney and a Ventura workers’ compensation lawyer for Ventura County, and a workers’ comp lawyer for West Covina and the San Gabriel Valley.