Workers’ Compensation Lawyer San Diego, CA

How does California's workers' compensation system work?

San Diego Workers' Compensation Attorneys

Attorney Robert McLaughlin was recently interviewed by Workers' Compensation Experts and was recommended by the president of the Workers Injury Law and Advocacy Group (WILG) as a source of information. Attorneys McLaughlin and Denise Sanchez are both members of WILG. In the interview, attorney McLaughlin discussed California workers' comp law and how it impacts injured workers.

Workers' compensation is a no-fault system designed to provide financial support to injured workers while they recover. While the laws differ from state to state, California has one of the most comprehensive and in-depth systems in the United States. Unlike many other states, all employers with at least one employee must provide workers' comp coverage to their workers. Only sole proprietors who have no employees are exempt from this law.

According to the Insurance Information Institute, more than 888,000 workplace injuries and illnesses occurred in private industry occupations during 2019. The top ten occupations with the most injuries and illnesses were:

  • Laborers - 64,160 injuries and illnesses
  • Truck drivers - 47,990 injuries and illnesses
  • Nursing assistants - 27,590 injuries and illnesses
  • Stockers and order filers - 27,390 injuries and illnesses
  • Retail salespersons - 24,870 injuries and illnesses
  • Light truck drivers - 23,070 injuries and illnesses
  • General maintenance and repair workers - 21,490 injuries and illnesses
  • Registered nurses - 20,150 injuries and illnesses
  • Construction workers - 19,790 injuries and illnesses
  • Janitors and cleaners - 18,680 injuries and illnesses

These occupations only make up a third of all workplace injuries and illnesses reported in 2019. That means, there are a lot of workers who need workers' compensation coverage.

What does California workers' comp coverage pay for?

Whether you need a couple of weeks off to recover from a minor injury or several months to recover from a serious injury or illness, workers' comp in California will have you covered. It pays for:

Medical expenses

This includes all reasonable and necessary medical expenses (current and future). If your workers' comp claim is denied, your employer's insurance company still has to pay for your medical expenses accrued from the time you filed your claim and when your claim was denied (the limit for this is $10,000).

Temporary disability benefits

Workers' comp pays for two-thirds of your average weekly wages prior to your injury or illness. Currently, the weekly minimum is $203.44 and the weekly maximum is $1,356.31. You can only receive temporary disability benefits if your doctor says you can't work while you're in recovery. You can continue to receive wage reimbursement until:

Your doctor says you can return to work.

You're able to work with modified duties (but still earn the same as you did prior to your injury).

You've reached the legal limit of payments (which is 104 weeks within five years after your injury or illness).

Permanent disability benefits

If you became permanently disabled due to a workplace injury or illness, you may be eligible for disability benefits. A permanent disability is one that impacts your ability to work and earn a living. This depends on the degree of your disability. The disability rating range is 1-100 percent. Benefits include:

Permanent partial disability - a permanent disability that affects your ability to work, but doesn't prevent you from performing modified tasks. Your permanent disability rating is below 100 percent, but the number of weeks you receive compensation will depend on your rating. If your rating is at 70 percent and you have maxed out your weekly benefits, then you may be eligible for a life pension.

Permanent total disability - a permanent disability that hinders your ability to perform any type of work. Your permanent disability rating is 100 percent.

Death benefits

If you lost a loved one due to a work-related injury or illness, you may be able to obtain death benefits. These include:

Burial costs - up to $10,000

Compensation to dependents - up to $320,000

Why getting workers' comp benefits is so complex in California

California has one of the better workers' compensation systems in the nation. Not only is there less of a burden on workers to prove that their injuries or illnesses were work-related (in comparison to other states), workers' comp covers a much wider range of injuries than most states. That includes psychological conditions, such as anxiety and PTSD.

That doesn't mean that California's workers' comp system doesn't have flaws. Some of the regulatory changes that have taken place over the years have favored businesses and insurance companies over injured workers. For example, we recently discussed how Proposition 22 affects the rights of injured gig workers in California. Lawmakers passed Proposition 22 late in 2020, which became effective on January 1st of 2021. The law exempts ride-sharing and food delivery companies from being forced to classify gig workers as employees (which was made a requirement under AB5).

Getting workers' compensation can be difficult even for workers who are classified as employees. Insurance companies often make the argument that workers' injuries or illnesses are "pre-existing" or "not work-related." That's why it's critical that you take the appropriate actions to pursue a claim promptly after a workplace injury or illness.

Getting started on your workers' compensation claim

First, you need to notify your employer of your injury or illness in writing as soon as possible. Make sure you include the date, time and location of your workplace accident or when you first discovered symptoms of an illness, such as the coronavirus.

See a doctor as soon as possible and let your doctor know you were hurt on the job. In California, you can generally choose your own doctor from a list provided by the employer after a workplace injury or illness. You must give your employer written notice of this, however. Your employer must also provide health care coverage for your work injury.

When filing a workers' compensation claim, make sure you first speak to an experienced attorney who knows how the system works. The award-winning San Diego attorneys at McLaughlin & Sanchez have more than 30 years of combined experience helping injured workers get the compensation they deserve. We'll ensure that there are no errors made in the filing process, all important documents are obtained, and your case is prepared for trial. Put experience on your side. Contact us online or call us to set up your free case review.

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