California’s workers’ compensation system offers financial relief to employees injured on the job. The benefits consist of medical care paid by the employer, disability payments for the inability to work (temporary or permanent), supplemental payments for job displacement, and death benefits.
If you’re injured on the job, you should be aware of the workers’ compensation laws that determine your eligibility for benefits and timelines for claims.
Eligibility
To qualify for workers’ compensation, you must show that you were injured as an employee in an accident occurring in the course and scope of your employment.
Employee or Independent Contractor?
In some cases, the claimant must establish as a threshold matter the status of an “employee.” Independent contractors do not qualify for workers’ compensation. California Labor Code Section 2750.5 deems you an employee rather than an independent contractor unless the would-be employer demonstrates:
- You retain the right to control the manner and details of your work, and
- You customarily engage in an independent trade or business of the same nature as the work out of which you were injured, and
- You show yourself to be an independent contractor through factors such as negotiating by contract or project rather than time, supplying your own tools and equipment, and holding yourself out as an independent contractor
No-Fault and Employer’s Defenses
To obtain workers’ compensation benefits, you need not establish that the employer was negligent or otherwise at fault in causing your injury. The employee’s negligence generally does not bar a workers’ compensation claim. However, California law renders an employee ineligible for benefits due to injuries caused by the employee’s own intoxication or willful misconduct. Also, an employee must take reasonable steps to not aggravate injuries.
Workers Exclusive Remedies
Generally, you cannot recover pain and suffering or other non-economic damages in a workers’ compensation case. Under California law, workers’ compensation benefits constitute the exclusive remedies against your employer except when the injury arises out of or involves:
- The employer’s fraudulently hiding the work-related nature of the injury or
- An assault ratified by the employer or
- The employer’s acting in a capacity other than employer, such as the manufacture of a defective product purchased or used by the employee outside of work
Personal Injury Claims Against Third Parties
You may sue third parties for damages caused by negligence even if your injury occurred on the job. In such personal injury claims, you must prove negligence (except for dog bite and product liability cases, which proceed on strict liability). Damages in personal injury cases include non-economic damages along with lost wages and medical expenses.
However, the employer or the workers’ compensation carrier can obtain reimbursement of benefits paid due to the third party’s negligence or other conduct. This may come through the filing of a lien on the personal injury recovery or settlement proceeds or a direct lawsuit by the workers’ compensation carrier against the third party.
Workers’ Compensation Insurance Requirements
In California, employers are required to carry workers’ compensation insurance. The mandate applies without regard to the number of employees or whether the workers are part-time or full-time.
Employers who fail to keep workers’ compensation insurance face:
- Fines
- Imprisonment
- Civil lawsuits by injured workers
Statute of Limitations for Workers’ Compensation Claim
Labor Code Section 5400 gives you thirty (30) days from the date of injury to report it to the employer. This requirement gives the employer an opportunity to promptly investigate the incident. If the employer does not deny within 90 days after you give notice, California law presumes that your injury is compensable. An employer who demonstrates prejudice from your failure to meet this deadline can defeat your claim.
Reporting the injury to the employer is not enough. You must file a workers’ compensation claim within one year after the injury, or the statute of limitations will bar your claim. Normally, the date of the accident triggers the one-year filing period. For cumulative injuries or occupational diseases, such as carpal tunnel syndrome, the statute of limitations starts when the employee learns or knows or should have learned or known that the injury or disease resulted from employment.
