If one of your workers is injured on the job, they have the right to file a worker’s compensation claim. This allows them to have their medical bills covered by your insurance company, and also to receive compensation for time lost if necessary. It’s important that all required forms be properly filled out and submitted in a timely manner, and both the employer and the employee have certain responsibilities in this regard.
It can be helpful to facilitate the proper filing of the claim, as well as beginning an open communication that will continue as long as the claim is open. The better the communication between you and your injured employee, the better the chances that the claim is resolved promptly and the employee returns to work successfully, which is a benefit to both parties.
Initial Claim Forms
The first form required to begin a worker’s compensation claim in California is the DWC-1 Claim Form. This includes separate sections for the employee and employer to fill out, and it asks for basic information regarding the parties involved and the details of the injury. The employee fills their section out first, and then turns it in to the employer, who completes their separate section within 24 hours of receiving it, and submits the form to the insurance carrier.
There is also an Employer’s Report of Occupational Injury or Illness, which is primarily completed by the employer, but that also has a section for the employee. Regardless of whether an employee files their own claim, you as an employer are responsible for reporting an on-the-job injury or exposure using this form within 5 days of learning of the occurrence.
Application for Adjudication of Claim
Any worker’s compensation claim will not be considered complete without an Application for Adjudication of Claim, or WCAB Form 1. This form has sections for both the employee and employer, and along with the standard information about the nature of the claim, it also asks the parties to select the jurisdiction in which the claim will be adjudicated.
Other Elements
There are several other forms and documents that may be required, either of the employer or the employee, to ensure an accurate and efficient processing of a worker’s comp claim in California, particularly if your insurance is through the State Compensation Insurance Fund. These include:
- Declaration Pursuant to Labor Code 4906(g): this is a form signed by the employee’s medical provider stating that they have not been paid to deliver inaccurate medical information.
- Express Scripts Pharmacy Registration Form: this is completed and presented at the pharmacy by the employee in order to receive prescriptions covered under the worker’s comp claim.
- Medical Mileage Expense Form: this allows employees to document reimbursable travel miles required to receive proper, covered medical treatment for their condition.
Navigating the paperwork surrounding a worker’s compensation claim can be a daunting task. The most important thing to keep in mind, though, is that all forms must be thoroughly completed with as much detailed, accurate information as possible, and returned promptly. If you’d like to learn more about the ways we can help you more efficiently manage the worker’s compensation claims process, contact our offices today.
