The Role of the Employer in Workers’ Compensation Cases

Workplace accidents are a common occurrence, and that’s even more true for people who work in dangerous industries. Such accidents have a high cost for both workers and their employers.

Workers’ compensation benefits can ease some of the financial burden if you’re hurt on the job. These benefits cover your medical bills and pay a part of your wages if you can’t work. But what are your employer’s obligations in the workers’ compensation claims process?

Learn more about employers and workers’ compensation cases here.

Do All Employers Need Workers’ Compensation Insurance in California?

State law requires all employers to hold workers’ compensation insurance, even if they only have a single employee. This coverage protects full- and part-time workers, seasonal workers, and family members who serve as employees.

Undocumented immigrants and workers who aren’t American citizens qualify for workers’ compensation benefits as well.

Workers’ compensation doesn’t cover every injured worker, though. Benefits don’t cover volunteers, sole proprietors, or independent contractors.

However, some employers misclassify employees as independent contractors to avoid paying overtime, payroll taxes, and workers’ compensation benefits. If you meet California’s definition of an employee, you qualify for workers’ compensation benefits regardless of what your employer classifies you as.

Workers’ Compensation Self-Insurance

Some employers may provide workers’ compensation benefits through their own assets rather than an insurance carrier. To qualify for self-insurance, an employer must:

  • Have net profits of at least $500,000 for the past five years
  • Have $5 million or more in shareholder equity
  • Make deposits on expected future liabilities (the minimum deposit is $220,000)

The law doesn’t allow certain employers to self-insure. These include temporary service employers, leasing employers, and professional employer organizations.

Does it matter if your employer self-insures or offers benefits through an insurance carrier? Regardless of which option they choose, you still qualify for the same types of benefits.

Workers’ Compensation Benefits Employers Must Offer

What do workers’ compensation benefits include? According to workers’ compensation laws, your employer’s carrier must provide benefits to pay for your medical bills.

For instance, if work-related injuries put you in the hospital and you need surgery, workers’ comp will pay for the bill. Benefits also cover wheelchairs and accessible transportation for disabled employees.

Workers’ comp pays for physical therapy to help you recover and return to work. If you can’t return to your former role, benefits will pay for tuition and retraining so you can find a different job that suits you.

If your accident left you disabled, workers’ comp pays benefits based on the severity of the disability. It may pay a portion of your wages until you’re well enough to return to work. It also provides benefits if you’re permanently disabled and cannot return to your job.

If an employee dies due to a workplace injury, workers’ comp pays benefits to surviving family members.

Injury Reporting Requirements

Employers must report any workplace injury that results in lost work time or medical treatment beyond first aid.

Your employer should provide you with a claim form within 24 hours of you reporting the injury to them. This form asks you questions about the nature of the accident, such as how it happened and who was involved.

The employer will also fill out their portion of the claim form and submit it to their insurance carrier.

Along with the claim form, your employer should give you a pamphlet with information about benefits and returning to work.

After submitting the claim, the insurance carrier may ask your employer for more information. It may ask about your work status, when the employer expects you to return to work, and your income before and after the injury.

Coverage Notice Requirements

Your workplace must post a notice regarding employers and workers’ compensation cases in an easily visible place. This poster should include information about your rights and the employer’s obligations.

If a large percentage of the employer’s workers speak a language other than English, the employer must post the notice in the foreign language that they speak.

Failing to post this notice is against the law. If your employer does not post a workers’ comp notice, it’s possible that they don’t have workers’ compensation coverage.

In this case, your employer must allow you to treat your injuries with the doctor of your choice.

For new hires, employers need to provide information about:

  • How to seek medical care for workplace accidents
  • The role of the primary treating physician
  • How to use their personal doctor for care if the employee wants to do so

Employers Cannot Retaliate Against Employees Who File Workers’ Compensation Claims

It’s illegal for your employer to retaliate against you for filing a workers’ comp claim or missing work due to a job-related injury. But that doesn’t stop some employers from trying.

Some employers may discourage you from filing a claim or try to interfere with the claims process. They know their premiums may increase if you make a claim, so they might try to convince you that you don’t need benefits after all. But you have rights to these benefits regardless of what your employer says.

Your employer may not try to fire you for filing a claim, but they might attempt other tricks as a subtle (or not-so-subtle) form of punishment. For instance, they may pass you up for a promotion or look for reasons to stop you from returning to work.

Instead of firing you outright, your employer may demote you to a lower-paying role or remove responsibilities from you.

All of these retaliation tactics are against the law. If you think that your employer has fired you or cut your pay because you filed a claim, contact a wokers’ comp attorney lawyer for advice.

Call Us If You Need Help With Your Workers’ Comp Claim

You likely expect everything to go smoothly when you file a workers’ comp claim, but it’s not always that simple. If workers’ comp denied you or you suspect your employer is breaking the law, we may be able to help you.

Call Khalil Law Group at (714) 617-7870 to learn more about employers and workers’ compensation cases today.

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