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How Workers’ Compensation Works

Understanding How Workers’ Compensation Works in California

Los Angeles attorneys help navigate the process for optimal results

In California as elsewhere in the U.S., workers’ compensation is the exclusive remedy available for a worker seeking money from an employer for lost wages and medical expenses due to a work-related injury or ailment. Unlike a personal injury case, a workers’ comp claim does not require the injured employee to prove that the workplace injury or illness was anyone’s fault. However, the extent of the injury and the amount of compensation sought are scrutinized by insurers in determining whether and how much to pay. At Goldschmid, Silver & Spindel, our experienced workers’ comp attorneys will negotiate on your behalf and protect your interests so the insurer pays what it should.

Following the California workers’ compensation claim process

A notice of claim for workers’ comp benefits generally must be filed with your employer within 30 days of a work-related injury, though different time computations apply in cases of cumulative trauma injuries or occupational diseases. After giving notice, you have as long as a year to file the actual claim. When that is submitted, your employer’s insurer must authorize payments for medical treatment while the claim is investigated. In the meantime, the insurer is responsible for up to $10,000 in medical bills. If you have to miss work because of your injury or illness, the insurance company should begin paying temporary benefits within 14 days after it receives notice. The insurance company has 90 days to approve or reject your claim or you will automatically be entitled to benefits.

Claim disputes and denials must follow procedures and deadlines set by law, including adjudications hearings and appeals that are best handled with the aid of a qualified workers’ compensation attorney.

How workers’ compensation payments are determined

The amount and duration of workers’ comp benefits are different depending on whether you are temporarily or permanently disabled and whether the disability is total or partial.

You are considered temporarily disabled if your doctor concludes that your work-related injury or illness prevents you from doing any part of your job for a length of time. Payments begin after you have missed three days of work or if you have been hospitalized. Temporary disability payments replace only about two-thirds of your average weekly pre-tax wages at the time of your injury, including overtime, the market value of job perks and wages from other jobs. You can receive temporary disability benefits for up to 104 weeks in a five-year period.

Permanent disability benefits are payable if your doctor determines your recovery will not improve in the next year. Total permanent disability benefits are payable if your doctor determines that you are unable to work in any capacity for the rest of your life. Partial permanent disability benefits are payable for disabilities less than 100 percent, based on these rating factors:

  • The doctor’s detailed report of your injury
  • How much the injury or illness limits the kinds of work you can do
  • Your age
  • Your occupation
  • Your physical or mental limitations
  • The impact of any previous injuries

The amount of weekly total and partial permanent disability payments may be similar, the rating percentage impacts how many weeks the payments last.

Assessing all of the factors that impact your impairment rating, negotiating with your employer’s insurance company and resolving disputes is complex. An experienced workers’ compensation lawyer from our firm can help you navigate the system and obtain the benefits you deserve.

Contact our compassionate and dedicated Los Angeles workers’ compensation attorneys

With more than 150 years of combined workers’ comp experience, Goldschmid, Silver & Spindel is a strong advocate for injured employees. We accept workers’ compensation cases on a contingent fee basis: we only get paid if we get your benefits approved. To learn more about how our firm can help you, schedule a free consultation by calling 213-251-5900 or contacting our Los Angeles office online.

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  • Los Angeles Office
    4221 Wilshire Boulevard
    Suite 460
    Los Angeles, California 90010
    Phone: 213-251-5900
    Fax: 213-386-2750
Million Dollar Results
  • "MULTIMILLION DOLLAR AWARD: For injuries sustained to a physician blood pathologist, after being exposed to formaldehyde in the workplace."

  • "MILLION DOLLAR SETTLEMENT: Verizon field technician injured at work incurring serious injuries to the lower back, neck (fusion) and upper/lower extremities."

  • "MILLION DOLLAR SETTLEMENT: Semi-truck driver involved in an out-of-state collision while working for a Hollywood entertainment company - resulting in severe lower back, neck, chest, head, urological and psychiatric disabilities."

  • "MILLION DOLLAR AWARD: A welder received compensation for his injuries as a result of cadmium exposure causing brain damage."

  • "$1.4 MILLION SETTLEMENT: A sheet metal installer was compensated after sustaining injuries to his entire body from falling 14ft off a scissors lift."

  • "MULTIMILLION DOLLAR AWARD: Versus Coca-Cola for an injured worker who fell from a forklift and struck his head sustaining blunt force trauma to his neck, spine and shoulder."

  • "OVER $ 1 MILLION DOLLAR SETTLEMENT: Southern California Edison Employee who sustained Fibromyalgia and Psychiatric consequences of the stress and wear-and-tear of her employment."

  • "MILLION DOLLAR AWARD: Versus Warner Brothers for employee who sustained severe spinal disabilities as a result of the physical wear-and-tear of his employment."