How Long Will a Workers’ Compensation Claim Take?

Employees who are injured on the job have the right to file a workers’ compensation claim to receive benefits. One of the most common questions is how long the process will take. Generally, once an employer’s insurance carrier has received the claim, they have 14 days to approve or deny it. If the claim is approved, benefits should be dispersed within a few weeks, depending on the type of benefits they are eligible for.

If the claim is denied, the employee has the right to appeal the decision and request a hearing with the California Workers’ Compensation Appeals Board. The appeals process can take several months to complete.

How to File a Workers’ Comp Claim

Here are the steps to follow to file a workers’ compensation claim in California:

Report the Injury

Notify your employer of the injury as soon as possible. You can do this orally or in writing, but it is always best to do it in writing or both so that you have a record of the incident.

Get Medical Treatment

Seek medical attention for your injury immediately after leaving the accident scene. Your employer may have a medical provider network that you are required to use, or you may be able to choose your own doctor. Make sure to keep all records of medical treatment related to your injury.

Fill Out a Claim Form

Your employer should provide you with a DWC-1 claim form within one working day of your report of injury. If they do not, you can obtain the form from the California Division of Workers’ Compensation (DWC) website. Fill out and turn in the form to your employer or their workers’ comp insurer, and keep a copy for your records.

Wait For a Decision

Your employer’s insurance carrier has up to 14 days to accept or deny your claim. If they deny your claim, they must provide a reason in writing.

Follow Up on Your Claim

If your claim is approved, you should start receiving benefits, such as medical treatment and wage replacement, within a few weeks. Contact the workers’ compensation insurance carrier if you do not hear anything or have questions about your claim.

Consult an Attorney

A Orange County workers’ compensation attorney can help you understand your rights and advise you on what benefits you may be entitled to, how to file a claim, and what to expect throughout the claims process. They will also communicate with your employer’s insurance company on your behalf, which can be especially helpful if you are not comfortable or able to do so.

Your attorney will negotiate with the insurer to ensure you receive the full range of benefits to which you are entitled. If your claim is denied or if you are not receiving the benefits you are warranted, an attorney can represent you in court.

Common Reasons for Workers’ Comp Claim Denials

• Insufficient evidence to prove that the injury was work-related.
• Employee failed to follow the proper procedure for filing a claim.
• The injury occurred outside of the scope of employment.
• Insufficient medical evidence to prove the severity of the injury.
• The employee was under the influence of drugs or alcohol at the time of the injury.
• The employee failed to seek medical treatment within the required time frame.
• The employee failed to provide sufficient documentation to support the claim.
• The employee was engaging in horseplay or other activities not related to job duties.

To avoid a claim denial and ensure you receive the benefits you deserve, arrange a free consultation with an attorney today if you have suffered an injury on the job.