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In a California workers’ compensation case, a claims adjuster is the representative from the insurance company who is responsible for managing your claim. Their role includes reviewing your case, approving or denying benefits, coordinating medical care, and determining how much compensation you may receive. The claims adjuster is often your main point of contact once…

In California, the Claim Form (DWC-1) is the official document an injured worker uses to notify their employer of a work-related injury or illness and to start the workers’ compensation process. Filing this form is a required step to receive benefits, including medical treatment, temporary disability payments, and permanent disability compensation. When Should You File…

In California, a carve-out refers to a special agreement between unions and employers that allows them to handle workers’ compensation claims outside of the standard state process. These programs are allowed under Labor Code Section 3201.5 (construction industry) and 3201.7 (non-construction unionized employers). Carve-outs are only available in unionized workplaces, and both the employer and…

California Labor Code Section 132a makes it illegal for an employer to discriminate, retaliate, or fire an employee for filing a workers’ compensation claim or for being injured on the job. This section exists to protect injured workers from unfair treatment and ensure they are not punished for exercising their legal right to seek benefits.…

Cal/OSHA stands for the California Division of Occupational Safety and Health, the state agency responsible for enforcing workplace safety and health regulations. While Cal/OSHA does not handle workers’ compensation claims directly, its role in investigating workplace hazards, accidents, and safety violations can impact a workers’ compensation case. What Does Cal/OSHA Do? Cal/OSHA’s primary duties include:…

In a California workers’ compensation case, a benefit notice is a written communication sent by the insurance company to an injured worker. This notice explains the status of benefits, including what benefits are approved, denied, delayed, or modified. Benefit notices are required by law and are meant to ensure that injured workers understand what to…

The Audit Unit is a division of the California Division of Workers’ Compensation (DWC) that monitors how insurance companies, self-insured employers, and third-party administrators handle workers’ compensation claims. Its goal is to ensure that claims are processed correctly, benefits are paid on time, and injured workers are treated fairly under California law. What Does the…

The Americans with Disabilities Act (ADA) is a federal law that protects individuals with disabilities from discrimination in the workplace. In a workers’ compensation case, the ADA may apply if an injured worker develops a lasting impairment that affects their ability to perform their job. Employers must provide reasonable accommodations to help injured workers return…

In a California workers’ compensation case, the terms AOE (Arising Out of Employment) and COE (Occurring in the Course of Employment) are used to determine whether an injury is work-related and eligible for benefits. If an injury meets both conditions, the worker may qualify for medical treatment and disability benefits through workers’ compensation. What Does…

In California workers’ compensation cases, an Application for Adjudication of Claim (often called an application or app) is a legal document that formally opens a case with the Workers’ Compensation Appeals Board (WCAB). Injured workers file this application when there is a dispute over benefits, such as a denied claim or disagreements about medical treatment,…