In a California workers’ compensation case, the date of injury is a critical detail. It determines when benefits may begin, how long you have to report the injury, and which laws apply to your claim. The date of injury is not always the same in every case, it depends on the type of injury and…
In California, death benefits are available through the workers’ compensation system when an employee dies as a result of a work-related injury or illness. These benefits are intended to provide financial support to the worker’s surviving dependents, including payment for burial expenses and ongoing support payments. The law is designed to ensure that families are…
A Declaration of Readiness to Proceed (DOR) is a form used in California workers’ compensation cases to request a hearing before a workers’ compensation judge. It is filed when one or more issues in a claim cannot be resolved through informal discussions and need to be addressed through a formal legal process. Filing a DOR…
In a California workers’ compensation case, the defendant is the party that responds to a claim filed by the injured worker, also known as the applicant. The defendant is typically the employer’s workers’ compensation insurance carrier, or in some cases, the employer directly if they are self-insured. The defendant’s role is to review the claim,…
A delay letter is a written notice sent by the workers’ compensation insurance company to let an injured worker know that their claim is still under investigation. It does not mean the claim is denied, it means the insurance company has not yet accepted or rejected liability. Under California law, if the claim is not…
The Commission on Health and Safety and Workers’ Compensation (CHSWC) is a public body established to improve how California’s workers’ compensation and workplace safety systems function. While it does not manage individual claims, it plays a key role in shaping the rules, procedures, and laws that impact injured workers and employers across the state. What…
Claims Adjuster vs. Claims Examiner vs. Claims Administrator If you have filed a workers’ compensation claim in California, you are likely dealing with someone from the insurance company but their title might be claims adjuster, claims examiner, or claims administrator. These terms can be confusing, especially because they are often used interchangeably. Understanding who is…
In most cases, the answer is no, but there are exceptions and specific situations where benefits may overlap. In California, workers who are temporarily unable to work due to an injury or illness may have access to wage replacement through different benefit programs. If your condition is work-related, workers’ compensation will usually apply. If it…
If you are receiving workers’ compensation in California and remain employed, your employer should continue paying their portion of your health insurance premiums. However, you are still responsible for your share of the cost. Since you may not be receiving a regular paycheck, you may need to pay your portion directly to maintain coverage. If…
In a California workers’ compensation case, a claims administrator is the person or organization responsible for handling a workers’ compensation claim on behalf of the employer. This can be someone who works for an insurance company, a third-party administrator (TPA), or an employer who is self-insured. The claims administrator plays a central role in the…
