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Injuries That Qualify for Workers’ Compensation

In California, our workers' compensation system is designed to help injured workers like you. It provides benefits to cover medical expenses, lost wages, and in some cases, disability. But navigating this system can be confusing, especially when you're already dealing with the aftermath of an injury. 

As someone who has dedicated their career to representing injured workers, I understand the immense challenges you face when you've been hurt on the job. The physical pain, the stress of medical bills, the uncertainty about your future – it's a lot to bear. That's why I'm here to help guide you through it, every step of the way.

From my firm, The Law Office of Cezar J. Torrez, I care about your situation. Serving Sacramento, California — including East Sacramento, Oak Park, South Natomas, North Sacramento, West Sacramento, North Natomas, Arden-Arcade, Rosemont, Lemon Hill, Pocket, Riverview, and more — I encourage you to reach out to my firm today for support. I am here to fight for your rights and for the compensation you deserve.  

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Injuries That Qualify for Workers’ Compensation Benefits

In California, workers' compensation is a no-fault system. This means that you don't have to prove that your employer was at fault for your injury to receive benefits, and there's a wide range of injuries that qualify for workers' compensation benefits. These include repetitive stress injuries like carpal tunnel syndrome, which are caused by performing the same motion over and over again at work, and more. 

Repetitive Stress Injuries

Repetitive stress injuries are common among office workers, factory workers, and others whose jobs require them to repeat the same physical tasks day after day.  

Orthopedic Injuries

Orthopedic injuries pertain to afflictions associated with the musculoskeletal system. These are common in workplaces where physical labor is prevalent, such as in construction sites, warehouses, and factories. However, they can also occur in office settings due to accidents or improper ergonomic setups. Orthopedic injuries can encompass a wide range of conditions from fractures, dislocations, and sprains to more severe injuries like torn ligaments or herniated discs. These injuries often result in painful and debilitating conditions that can limit your ability to work.  

Other Injuries Covered

Workers' compensation also covers a range of other injuries that can occur in the workplace. Occupational illnesses, such as lung diseases caused by exposure to harmful substances, are covered. So are traumatic injuries like broken bones, burns, or head injuries suffered in a workplace accident. Mental and emotional injuries, such as those caused by workplace harassment or stress, may also be covered. Even injuries incurred during work-related travel or at a work-sponsored event may qualify for benefits. The key is that the injury or illness must arise out of, and in the course of, your employment. 

Injuries Not Covered

It's important to note that not all injuries are covered by workers' compensation. Here are some types of injuries that are generally not covered: 

  • Injuries sustained while commuting to or from work 

  • Injuries resulting from intoxication or drug use at work 

  • Injuries sustained while committing a serious crime at work 

  • Self-inflicted injuries (including those arising from a fight the worker started) 

  • Injuries incurred while violating company policy 

  • Injuries sustained while the worker was off-duty or on a break 

  • Injuries from natural disasters, unless the job increases the risk of harm from the disaster 

Understanding what injuries qualify for workers' compensation is the first step in securing the benefits you rightfully deserve.  

Workers' Compensation for Remote Workers

Contrary to what some might think, injuries sustained while working from home can indeed qualify for workers' compensation benefits. As a remote worker, you are still performing duties on behalf of your employer, thus the same principles apply. However, it can be more challenging to prove that an injury or illness arose out of and in the course of employment when working from home due to the blurred boundaries between work and personal life.  

It is advisable to maintain clear work hours and a dedicated workspace to help separate work activities from personal ones. This can help in establishing that an injury occurred during the course of employment. As always, it's important to report any injury to your employer as soon as possible and seek prompt medical attention. Keep detailed records of the incident, your work schedule, and any communications regarding your work-from-home arrangement. 

Available Benefits

Workers' compensation offers several types of benefits, including medical care, temporary disability benefits, permanent disability benefits, supplemental job displacement benefits, and death benefits. 

Permanent Partial Disability

If your injury has left you with a permanent disability that partially affects your ability to work, you may be eligible for permanent partial disability benefits. These benefits are designed to compensate you for your lost earning capacity. 

Temporary Total Disability

If you're unable to work at all while you recover from your injury, you may qualify for temporary total disability benefits. These benefits are typically two-thirds of your average weekly wage, up to a maximum amount set by law. 

Supplemental Job Displacement Benefits

Supplemental Job Displacement Benefits (SJDB) are a unique feature of the workers' compensation system in California. If you are unable to return to your previous job due to the severity of your work-related injury, SJDB offers you a voucher to be used for educational retraining or skill enhancement at approved schools. This voucher covers school tuition, fees, books, and other necessary expenses, helping you transition into a new line of work that accommodates your physical limitations. Keep in mind, eligibility for SJDB and the value of the voucher depend on several factors including the nature of your injury and the date of your injury. 

Death Benefits

Death benefits are provided to the spouse, children, or other dependents of a worker who dies from a work-related injury or illness. In the unfortunate event of such a tragedy, California's workers' compensation system aims to provide financial support to help alleviate some of the burden faced by the deceased worker's family. These benefits include coverage of funeral and burial expenses, as well as a set amount paid to the dependents to replace a portion of the deceased worker's lost wages. The exact amount of these benefits is determined by the number of dependents and their level of dependency on the deceased worker's income. 

How to File a Workers’ Compensation Claim in California

Filing a workers’ compensation claim can often seem like a daunting process, especially when you are already dealing with the stress and pain of an injury sustained at work. However, it's important to understand that this process is essential to receive the benefits you are entitled to for your work-related injury. 

  1. Report the Injury: The first step in filing a workers' compensation claim is to report your injury to your employer. You should do this as soon as possible, but no later than 30 days after the injury occurs. If it's an occupational illness, you should report it as soon as you become aware of it. It is best to do this in writing and keep a copy for your records. 

  1. Seek Medical Attention: After reporting your injury, seek immediate medical treatment. Make sure to inform the healthcare provider that your injury is work-related. Their report will serve as crucial medical evidence for your claim. 

  1. Complete a Claim Form: Your employer should provide you with a DWC-1 claim form after you've reported your injury. Fill out the employee section of the form, detailing the nature of your injury or illness, and return it to your employer. Your employer is then required to fill out the employer section and submit the form to their insurance company within one working day. 

  1. Follow Up: The insurer has 14 days to send you a letter informing you about the status of your claim. If your claim is approved, you'll start receiving benefits. If it's denied or delayed, seek legal advice. 

  1. Appealing a Denial: Sometimes, workers' compensation claims are denied. This can happen for a variety of reasons, such as a lack of medical evidence or a dispute about whether the injury occurred at work. If your claim is denied, you can file an appeal with the Workers' Compensation Appeals Board. It's highly recommended to have a workers' compensation lawyer assist you with the appeal process, as it can be complex and requires detailed knowledge of the law. 

Remember, it's important to keep copies of all correspondence, medical bills, and documents related to your injury and claim. These will be crucial in any disputes or appeals. 

Take Control of Your Workers' Compensation Journey 

Navigating the workers' compensation system can be challenging, but you don't have to do it alone. I'm here to guide you through the process and fight for the benefits you deserve. Don't hesitate to contact my office for a free consultation. Let's discuss your case and explore your options together. The Law Office of Cezar J. Torrez is here to support you through this challenging time, so reach out today for support.