California Workers' Comp: Everything You Need to Know

Work injuries are stressful. In addition to getting medical care and recovering, you need to file for workers’ comp. Workers’ comp will replace some of your wages if you need to miss work, and California has a robust benefits system. We’ll break down how workers’ compensation works in California and what you should know so you can navigate the process as smoothly as possible.

Who qualifies for workers’ comp in California?

You can qualify for workers’ comp benefits in California if you get injured or sick on the job. Your injury will have to either require an overnight hospital stay or put you out of work for more than three days.

Benefits are available no matter whose fault the injury was and you don’t need to be a legal resident in California to qualify. Full-time, part-time, and seasonal employees are eligible to receive benefits.

Independent contractors don’t qualify, but even if your employer calls you an independent contractor, it’s possible you’re a part-time worker. For example, if your job pays you an hourly wage, requires you to work specific hours, or deducts taxes from your income, then you probably aren’t an independent contractor.

As a general rule, if you receive a W-2 from a job, you qualify for workers’ comp in California.

Injuries that qualify for workers’ comp

It’s possible to get worker’s comp because of a one-time event — like a fall or car accident — or through repeated exposure — like losing your hearing because of constant loud noise or hurting your back because you’ve done the same lifting motion repeatedly for years.

Stress-related and psychological injuries can qualify for workers’ comp too. However, you may have a harder time proving to insurers that these injuries were directly caused by your job. With stress-related injuries, we suggest finding a workers’ comp lawyer. They can help you get the benefits you deserve.

Atticus can help you with your workers’ comp claim, and find you a lawyer if you need one. Fill out our 2-minute workers' comp quiz and someone from our team will reach out to you about next steps.

Injuries that don’t qualify for workers’ comp

Injuries and illnesses you get outside of work don’t qualify for workers’ compensation, even if they leave you unable to work. For example, getting into a car accident on your way into or out of work wouldn’t qualify unless that drive is actually part of your job.

Workers’ comp also may not cover injuries that you report after your employer has notified you that you’re being laid off or that your job is being terminated.

The workers’ comp process in California

To get any workers’ comp benefits, there are certain steps you must follow. Here are seven actions to take while filing for workers’ comp in California:

1. Tell your employer about the injury

2. Receive emergency care if necessary

3. File a workers’ comp claim

4. Speak with a workers’ comp lawyer

5. Get treatment for your injury

6. Work toward maximum medical improvement

7. Return to work or receive permanent benefits

1. Tell your employer about the injury

You should notify your boss, manager, or supervisor that you were injured on the job as soon as possible. The workers’ comp process will only start after you notify your employer. If you wait more than 30 days to tell them, you may completely miss out on benefits.

2. Receive emergency care if necessary

If your injury requires emergency medical attention, you have a right to go to an emergency room for care. Your employer may instruct you to see a specific doctor.

Tell whichever doctor you see that you were injured at work. Once the doctor knows it’s a work injury, they should bill your employer instead of you. The state requires your employer to pay for up to $10,000 of medical care even before your workers’ comp claim is approved or denied.

3. File a workers’ comp claim

After you report your injury, your employer has one work day to give (or mail) you a Workers’ Compensation Claim Form (DWC 1). Fill out the employee portion of this form to officially file a workers’ comp claim.

Return the form to your employer so they can fill out their portion of the form and sign it. Then they have one day to send you a copy of the completed form. Keep this copy for your records.

At that point, your employer will send the form to their claims administrator — usually someone working for an insurance company — who decides whether to accept or deny your claim.

4. Speak with a workers’ comp lawyer

Not everyone needs a worker’s comp lawyer but just about everyone could benefit from having one. A lawyer will guide you through the whole workers’ comp process, helping you deal with doctors, your employer, and insurance companies. They can help if your claim was denied and they can represent you if your employer wants you to sign a settlement agreement.

As long as you find a good lawyer, you won’t need to pay them until you actually receive workers’ comp payments or some kind of settlement.

Learn more about when you should get a workers’ comp lawyer.

5. Get treatment for your injury 

You can continue receiving treatment for your injury as long as it’s medically necessary. And you shouldn’t have to pay for that treatment. Your doctor and your employer’s claims administrator will handle payment for all necessary care.

Your employer’s insurance company will most likely give you a list of workers’ comp doctors who you can see. Whichever doctor you choose will be called your primary treating physician (PTP). They will diagnose your injury and provide a disability rating. This rating determines how much you get from workers’ comp and how long your payments last.

Always be honest with the doctor. If you make your injury seem less severe than it is, you may get smaller workers’ comp payments or be expected to go back to work before you’re ready. Your primary treating physician will also determine whether you are able to do limited work or different kinds of work while recovering from your injury.

6. Work toward maximum medical improvement

Your doctor will advise you until you reach maximum medical improvement (MMI). MMI is the point where you have recovered as much as possible from the injury. Many people will experience a full recovery and return to work. Some people may take years to recover or never experience a full recovery.

At this time, the doctor will write a permanent & stationary report (P&S report) that explains your condition and any limitations you’d experience at work.

If you need months or years to reach MMI, the insurance company may try to reach a settlement. The law requires them to pay for your treatments up until you reach MMI, so settling helps them avoid long-term payments. Look for a worker’s comp lawyer if the insurer wants to settle.

7. Return to work or receive permanent benefits

After you reach maximum medical improvement, your doctor may clear you to go back to work, at which point your workers’ comp benefits end. If you still can’t return to work or if you can’t return to the same work you had before injury, you may qualify to receive California’s long-term, permanent disability benefits. (You may also qualify for a federal benefits program called SSDI).

How to apply for workers’ comp in California

If you’re injured at work, the first two things you should do are report the injury to your supervisor or to company management as soon as possible, and make sure you receive any emergency medical care.

Your employer has one day after you report your injury to give (or mail) you a copy of a Workers’ Compensation Claim Form (DWC 1). Fill out the employee section of the form and return it to your employer. If you need to mail the form, use certified mail and keep the receipt for your records.

You’ve now filed a workers’ compensation claim.

Next, your company will fill out the employer portion of the form, sign it, and send you a copy of the completed form within one day. Always keep a copy of the completed form for your personal records.

Once the form is finished, it goes to your employer’s insurance company so they can decide whether to approve or deny your claim.

Types of workers’ comp in California

There are two types of workers’ compensation in California: temporary disability and permanent disability.

Temporary disability benefits last a few months and are available right after someone gets injured at work. Most people will receive temporary benefits, which offer short-term income for people who miss time because of their injury.

Permanent disability is paid to workers who will never recover fully from their workplace injury and it can be either partial or total based on how serious your injury is. Permanent benefits are available if your temporary benefits run out and you still haven’t fully recovered.

Even if you do recover but you’re unable to do the same work you did before the injury, it’s possible to qualify for permanent disability benefits.

Temporary vs. permanent workers’ comp benefits

What other benefits does workers’ comp include?

In California, workers’ compensation offers five main benefits:

• Medical care paid by your employer

• Temporary disability benefits after injury, paid every two weeks

• Permanent disability benefits, paid weekly, if your temporary benefits run out but you never fully recover from your injury

• Supplemental job displacement benefits to help you pay for new job training, certifications, or licenses if you have permanent disability

• Death benefits for your spouse or dependents if you die from your injury

How much does workers’ comp pay in California?

How much you get from workers’ comp depends on whether you receive temporary or permanent benefits, and your wages before your injury.

For temporary workers’ comp benefits in California, most people receive weekly payments worth two-thirds of their job’s gross pay at the time of injury. However, if you were injured in 2022 and made less than $346.43 per week prior to your injury, you’ll receive a set payment of $230.95 per week.

For permanent workers’ comp benefits in 2022, payments are generally worth two-thirds of your gross wages from before your injury, with a minimum payment of $240 and a maximum payment of $435.

You can find a complete breakdown of payments in our guide to California workers’ comp payments which includes mileage reimbursement rates and death benefit amounts.

Are workers’ comp benefits taxable?

No, your California worker’s comp payments aren’t taxable. But if you return to work while receiving benefits, you will pay taxes on your work income as usual.

When do workers’ comp payments start?

Luckily, payments should start quickly. In California, workers’ comp benefits must legally start within 14 days once your employer documents the injury. If you ever need to transition to permanent benefits, payments should start within 14 days of your temporary benefits ending.

If your payments are going to arrive late, your employer’s claims administrator has to send you a letter explaining why you won’t receive your payment on time. If the administrator sends you late payment and it’s been at least 14 days since you filed your claim, you could have a right to an extra 10% or more of your payment.

Keep all letters you receive from the claims administrator. Also keep the envelopes from checks you receive in the mail because the postmark dates will make it easier to prove that a payment was sent late.

How long you can be on workers’ comp

Temporary disability payments usually last up to 104 weeks (two years), but they can last up to 240 weeks in severe cases. (If your recovery looks like it will last years, your employer’s insurance company may try to reach a settlement, so that you get a lump-sum payment up front. We suggest finding a workers’ comp lawyer to help you maximize your settlement.)

Permanent disability payments could potentially last the rest of your life if you qualify for total permanent disability, but you’re unlikely to qualify unless you truly can never work again. Partial permanent disability benefits last up to a maximum of 1,596 weeks (more than 30 and a half years). And if you find yourself unable to work for the long-term, you may qualify for other disability benefit programs.

For more information, read our article on how long workers’ comp lasts in California.

Can you work while on workers’ comp in California?

Yes, you can work while receiving California workers’ comp, but you should only do work that has been approved by your primary treating physician. That may mean returning to work with reduced hours or in a slightly different role.

Your PTP has to create a medical report that explains what kinds of work you can do, including how your current job’s schedule or tasks would need to change. Make sure to review your doctor’s report.

If the medical report says you can do more work than you think you can actually do with your injury, you need to tell your employer’s claims administrator as soon as possible. Then you’d need a separate medical evaluation from a qualified medical evaluator (QME).

We strongly recommend getting a workers’ comp lawyer if you ever disagree with your doctor’s assessment. The lawyer can handle the necessary paperwork for you to dispute your doctor’s report and to help you get a more accurate evaluation from another doctor.

How Atticus can help with California workers’ comp

Workers’ comp is long and confusing, with various deadlines and paperwork that you need to fill out. Atticus can offer free advice on the best way to handle your claim. We can also connect you with a workers’ comp lawyer to guide you through the process. Contact Atticus today for help handling your workplace injury.