After You Get Injured

Basic infomation every employee should know after sustaining a work-related injury includes:

Take an Active Role

No one in the workers' compensation system will be as interested in your case and your benefits as you are, and therefore it is in your best interest to take an active role in your case. If you don't actively seek benefits that you are entitled too, you many not receive them. Start a file and keep good records. There will be extensive paper work and you will want to keep it organized for easy reference, especially if the case ends up in court. Tracking what benefits you have received will facilitate determining what benefits you are owed.

Compensable Injuries

A compensable injury is any injury or condition that occurs at work and causes pain or discomfort and is paid for by your companies workers' compensation insurance. If you are unsure if your injury or condition is work related, just contact us, and a doctor will answer your questions. For an injury to be considered work related it must arise out of employment (AOE) and/or occur in the course of employment (COE).

There are some injuries that will not be covered by worker's compensation (LC 3600). We recommend that you contact us and a doctor will help determine if your injury is covered by workers' compensation.

Report the Injury

Report the cumulative or specific injury to your employer immediately, regardless of whose fault you think it is. The workers' compensations system is a "no fault" system and an injury (LC 3208) is covered without regard to fault, as long as the injury arose out of and/or occurred in the course of employment (LC 3600). The employer is required to provide you with a First Report of Injury or Illness form, and the Application for Adjudication of Claim form. This form must be provided within twenty four hours of requesting it (LC 5401). The employer must also inform you in writing of your right to request a change of treating physician (CCR 9782).

Date of Injury

The date of injury is particularly important for cumulative trauma injuries and is the date when the employee first suffered an injury or knew that the injury was caused by the employment (LC 5412). This date will determine the benefits that you receive. There have been many changes to the work comp system in recent years and they are not retroactive.

Time Frame for Filing a Claim

The First Report of Injury or Illness form and the Application for Adjudication of Claim form must be filed within one year of the date of injury. The longer you wait to file a claim, the greater the likelihood the carrier will deny the claim.

Multiple Employers Within a One-Year Time Frame

If you have sustained a cumulative trauma (repetitive motion) injury, where a previous employer may have some responsibility, and you have been with a new employer for less than one year, you must file a First Report of Injury or Illness and an Application for Adjudication of Claim with each employer. For example, if you sustained a repetitive motion injury that started with a previous employer, and you have been working for a new employer for less than one year, both employers may carry some level of liability. Therefore, both employers must receive these forms. The one-year time frame represents the statute of limitations for filing a workers' compensation claim, and employers outside of that time frame are legally absolved from any further liability.

Change of Physician

Within the first 30 days of treatment for a work-related claim, if you are unhappy with the treatment you are receiving, or would like to see a different doctor, have your doctor of choice file a Change of Physician form with your insurance company (LC 4600, CCR 9781). Call your carrier and verbally request a change of physician. Follow up with a letter stating the same thing. Keep a copy for your own records. The insurance company will have 5 working days to provide you with a new physician (CCR 9781, 9782). After five days, you can choose your own doctor.

Cure or Relieve the Effects of the Industrial Injury

Your doctor is permitted to provide any treatment that will cure or relieve the effects of the work-related injury, at the expense of the insurance company (LC 4600). This includes the drug-free, non-invasive option of chiropractic treatment.

Primary Treating Physician

Only one primary treating physician (PTP) is permitted per case, however your injury may be co-managed by a group of doctors. These doctors must report to the PTP, and the PTP is responsible for managing the direction of your care and reporting to the insurance carrier. At ChiroComp, we are available as either the PTP or as a member of the team treating you.

Workers' Compensation Benefits

Get familiar with the workers compensation benefits that the law entitles you to. These should be conspicuously posted at your place of work (LC 3550), and include:

• Medical Treatment
• Temporary Disability
• Permanent Disability
• Vocational Rehabilitation
• Acute In-Patient Hospital Services
• Out-Patient Services, including:
  • Chiropractic and physical therapy
  • Diagnostic and treatment services
  • Occupational therapy
  • Other outpatient basis hospital services
• Other services, such as
  • Workplace safety and health services
  • How to avoid work related injuries
  • Education on creating a safer workplace
  • Return to work programs
  • Modified work programs

A detailed list of benefits can be found at the California Division of Workers' Compensation section of the official State of California web site.

More Information on Work-Related Injuries

For continued information click here.