Am I Eligible for Workers' Comp Benefits?

Employers in California are required by law to provide workers’ compensation benefits to any worker that gets injured on the job. For example, if an employee gets his hand caught in heavy machinery and is injured, they could receive compensation for medical bills, loss of wages, and permanent disability. However, there are eligibility requirements for workers’ compensation and not all injuries will qualify.

Typically, there are three basic eligibility requirements for workers’ compensation:

• Your employer must carry workers’ compensation or be legally required to do so;
• You must be an employee of that company; and
• Your injury or illness must be work-related.

Regardless of fault, you are eligible to receive benefits, but the accident must be work-related. As a result, you may not get workers’ compensation for the following situations:

• You trip and fall and break your leg at a restaurant while on lunch break
• You’re injured at a company event, such as a baseball game, corporate picnic or holiday party
• You’re hurt while traveling to and from work, such as in a car accident
• You violate a workplace safety rule, such as drinking alcohol or acting negligently

If you suffer a work-related injury, yet there is a disagreement regarding whether or not the injury should be covered under workers’ compensation, you have a right to challenge this decision. When this occurs, you must first have an evaluation performed by a qualified medical evaluator. You must then file a case at a Division of Worker’s Compensation office and file an Application for Adjudication of a Claim and a Declaration of Readiness to Proceed; the latter allows you to request a hearing before a judge. At the hearing, you and the claims administrator will appear before a judge and discuss a settlement. If one cannot be reached, the case will go to trial.

If you’re embroiled in workers’ compensation matters, contact our Bakersfield workers' compensation attorney at Berry, Smith & Bartell, a Professional Law Corporation.