WORK COMP FAQ – Law Offices of Cleveland & Metz
Frequent Questions: Workers Compensation in California
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Work Comp FAQ – Welcome. Below you’ll find answers to many of the common questions injured workers ask about California’s workers’ compensation system. Every case is unique — if your situation doesn’t quite match what you read here, please contact us. Our firm is here to support injured workers and their families.
- Should I retain a workers’ compensation attorney?
- What is my claim worth?
- How much does it cost to retain an attorney?
- Does it cost anything to find out if I have a good workers compensations claim?
- I am injured therefore, unable to travel. Do I have to go to your office in order to retain your law firm?
- If I file a workers’ compensation claim can my boss fire me?
- How much experience does your law firm have?
- I already hired a lawyer but I am not happy with their representation. Is it difficult to retain a lawyer to represent me?
- Should I trust the doctor that my employer or insurance company is sending me to?
- Why do I need a workers’ compensation attorney?
- What is Worker’s Compensation?
- If I am initially treated by an insurance company doctor, do I have a right to see my own doctor at some point?
- Medical care and benefits?
- Permanent Disability payments?
- What if my claim is denied?
- Can I continue to work if I file a workers’ compensation claim?
- What types of settlements are available?
- Can I receive medical treatment if I have been released by my doctor?
- Do I have a possible work injury claim from my work injury?
- If I receive workers’ compensation, can I also sue my employer in court?
- What kind of medical care am I entitled to?
- What if my employer insists I work after I got injured?
- Should I report the injury to my employer?
- What if they ignore me? Will I get fired?
- Can I stay at my job if I open a claim?
- What if I worked at a job that pays me cash?
- What if I am working illegally or are a non resident?
- What if I am a volunteer?
- What if I die?
- Is workers compensation only for physical injuries?
- What if my employer did something intentionally or grossly negligent to me?
- What if my employer did nothing wrong, but I was injured?
- What if I was partially at fault?
- What if I have a previous injury?
- What if I have a criminal record?
- Are all on the job injuries covered by workers’ compensation?
Should I retain a workers’ compensation attorney?
If you’ve been hurt on the job, you can represent yourself or hire a lawyer. It may seem simpler to go it alone but the law and the insurance system in California are complex. Insurance companies and their lawyers know how to navigate the system; if you don’t, mistakes can happen that are hard to undo later. An experienced workers’ compensation attorney will guide you through the process, help secure needed medical treatment, temporary disability pay, and aim for a fair permanent disability outcome. Since the employer’s carrier usually has legal representation, it makes sense for you to have it too.
There’s no “one size fits all” answer. The value of your claim depends on how severe your injury is, how it affects your ability to work, what medical treatment you need, and what future limitations you might have. A trustworthy lawyer won’t promise a dollar figure before knowing the facts. What you are worth is tied to evidence: medical reports, your work history, how the injury affects your future earning capacity, and more. Having legal help means your rights are protected as we evaluate all of that together.
How much does it cost to retain an attorney? At our office, your first consult is free. We handle work‐injury claims on a contingency basis, which means you don’t pay any attorney’s fee unless we obtain a result for you. In California workers’ compensation, the fee percentage is set by the Court. We request 15% of the recovery as our fee in most cases this is consistent with longstanding practice since 1997. Beware any attorney who asks for an upfront payment for a workers’ compensation case — that is not allowed
Does it cost anything to find out if I have a good workers compensation claim?
No, there is absolutely no cost to find out. The consultation is free. You will never receive a bill from us, and you will not pay attorney fees out of your own pocket. The attorney fee comes out of the recovery (if there is one), and only if your claim succeeds. The attorney fee is 15% of the settlement or award.
I am injured therefore, unable to travel. Do I have to go to your office in order to retain your law firm?
No — we’ve got you covered. If you are unable to come in, we can arrange for one of our investigators to meet you at your home (often the same day you call). We can set up a zoom call or an over the phone consultation and complete all paperwork necessary using DocuSign for electronic document management.Our goal is to make things as easy and accessible as possible for you.
If I file a workers’ compensation claim can my boss fire me?
No. It is illegal for an employer to retaliate or discriminate against you just because you filed or plan to file a workers’ compensation claim. If you believe you were fired for making a claim, we’ll help you connect with an employment or wrongful‐termination attorney to explore additional remedies
How much experience does your law firm have? We’ve handled thousands of workers’ compensation claims and bring over 52 years of combined litigation experience in this area. We’re members of the California Applicants’ Attorneys Association and the Consumers Attorneys Association of Los Angeles. One of our attorneys, Charles Cleveland has been a Certified Specialist in Workers’ Compensation Law with the California State Bar for over 10 years.
I already hired a lawyer but I am not happy with their representation. Is it difficult to retain a lawyer to represent me?
You can change lawyers at any time. We can review your file and tell you whether keeping your current attorney makes sense or whether switching is appropriate. If we decide your case has been neglected, we’ll help you transition smoothly and take over the handling from there.
Should I trust the doctor that my employer or insurance company is sending me to?
Not automatically. In California, your employer usually directs you to a clinic or doctor within their Medical Provider Network (MPN). That doctor works for the system set up by the employer’s insurance, so it’s wise to get legal advice about your choices. A good attorney will help you select the best treating doctor in the network and, if needed, assist you in securing a Qualified Medical Evaluator (QME) or going to trial if necessary. Trusting the insurance-company doctor without guidance can be risky.
You must remember that the industrial medical clinic and insurance company doctors are paid by the insurance company. They have to deal with the insurance company every day in order to maintain their business. They only have to deal with you once. Think about it.
Why do I need a workers compensation attorney? An experienced workers compensation attorney will protect your rights. We will deal with your employer’s insurance company and attorney so that you can be relieved of a lot of the stress involved with being injured. You may need a lawyer because of complex legal rules involved in your claim process, or because the severity of your injuries might cause your compensation to vary greatly from the norm, because an insurance company refuses to settle a matter in good faith or if your claim is being denied based on a doctor’s report that claims you are not injured. An attorney will attempt to prove your injury is work related by gathering the appropriate medical evidence. A work compensation attorney will also ensure that you select a doctor in the MPN (Medical Provider Network) proper medical care, and document your injuries so that you receive appropriate compensation according to the Labor Code.
Why do I need a workers compensation attorney? Workers’ compensation is a no-fault system that gives an injured worker benefits without needing to prove someone else caused the injury. If you’re hurt on the job or suffer a work-related illness that keeps you from working, you may qualify for benefits like medical treatment and disability payments. This system is your avenue for recovery — it’s not a lawsuit against your employer. It is designed to help you return to health and work while protecting employers from lawsuits, in exchange for the benefits you receive.
If I am initially treated by an insurance company doctor, do I have a right to see my own doctor at some point?
Yes — you have rights. If your employer’s MPN applies, you must first select a doctor from that network. You may have the right to a second opinion if your injury is serious. If there’s a dispute about your treatment, you may move to a QME panel evaluation. Navigating this properly is important and an attorney can help you decide the best steps.
You are entitled to all reasonably necessary medical treatment to cure or relieve the effects of your work-related injury. In California, once your injury is properly reported and accepted, your employer (through their insurance) must provide that care. For accepted injuries, the employer controls treatment via their medical provider network. Choosing the right treating doctor is crucial. As your firm, we can help you with that choice and make sure you get the treatment you need.
Temporary Total Disability Payments If your treating doctor states you cannot do your usual work and your employer does not offer modified work, you may qualify for Temporary Total Disability (TTD) benefits. These payments are based on your average weekly earnings on the date of injury. In California, the rate is two-thirds of your average weekly earnings (subject to minimum/maximum weekly rates set by law). These benefits generally continue while you’re unable to work, up to the legal limit.
Permanent Disability Payments If your injury leaves you with a lasting impairment or diminished ability to earn, you may receive “Permanent Disability” benefits. Your doctor or a Qualified Medical Evaluator will assess your disability percentage. The payment amount depends on that percentage plus your age, occupation, wages, and the date of injury. Even if you return to work, you might still qualify for these benefits. It’s also key to know that you are not eligible for separate payments for pain and suffering, lost wages beyond what the statute allows, or inconvenience — workers’ compensation is benefits-based, not a personal injury lawsuit.
What if my claim is denied? If your employer’s insurance carrier denies your claim, it’s serious — but you still have options. First, the carrier may place your claim on a 90-day delay while investigating. If denied, you must prove the injury happened “in the course of employment” and “arising out of employment.” Common denials involve claims notices that say something like “no substantial medical evidence to support industrial injury” or something like that. Or you were an independent contractor, that your injury didn’t come from work, or that you didn’t sign the required medical authorization. If denied, you should file for State Disability Insurance (if eligible) and file an Application for Adjudication of Claim with the Workers’ Compensation Appeals Board (WCAB) within one year of the injury date. Missing that deadline generally means you lose your right to the claim forever
Can I continue to work if I file a workers’ compensation claim?
Yes. Filing a claim doesn’t mean you must stop working. If you’re cleared by your doctor to work or can do modified duty, you can continue your job. Even if you work, you may still be eligible for permanent disability or future medical treatment benefits. The key is your injury’s impact — not whether you’re working now. Don’t confuse “able to return to work” with “no rights left.” Even working, you might still have significant benefits pending.
What types of settlements are available?
In California, there are three common paths to resolve a workers’ compensation case:
- Trial: Your case goes to a WCAB hearing; the judge issues a “Findings & Award” covering medical care, disability, etc.
- Compromise & Release (C&R): A lump-sum settlement that ends the insurance company’s liability for almost all future benefits (except sometimes vocational rehab). Once you sign, you generally give up your rights to future medical treatment for the injury.
- Stipulation with Request for Award (Stip/R): You agree with the carrier and attorney on a permanent disability rating and get future medical treatment spelled out. You also receive ongoing instalments for disability plus medical care for life (or for the body part injured). You still give up some rights, but keep future treatment and benefits.
Your attorney will explain which kind fits your case
Can I receive medical treatment if I have been released by my doctor? If your treating doctor says you’re done with treatment (a “maximum medical improvement” status) but you believe you still need care, you might still have rights. You can ask that doctor to reopen treatment, or you can obtain an opinion from a QME or panel doctor who may determine additional care is needed. If that happens, the matter can be disputed at the WCAB. Do not assume you’re out of care just because your initial doctor said so — get a second opinion if necessary.
Do I have a possible work injury claim from my work injury?
Yes — in many cases. The workers’ compensation system is your primary remedy for a job-injury, but in certain situations you may also have additional legal claims:
- If your employer was willfully uninsured and caused your injury, you might sue them directly.
- If someone other than your employer caused your injury (e.g., a negligent contractor, vehicle driver, third-party product), you may have a separate lawsuit in addition to your workers’ comp claim.
- If your employer is a government entity, you may need to file a formal written claim within six months of the injury date before starting a lawsuit.
- Most non-workers’-comp civil claims have a two-year statute of limitations (for injuries occurring since 2003) — so timely action is important
Legal advice is highly recommended in these situations.
If I receive workers’ compensation, can I also sue my employer in court? In most cases: no. The workers’ compensation system is the “exclusive remedy” against your employer for job injuries. In exchange for getting benefits without proving fault, you generally give up the right to sue your employer in court for negligence. The exception: if someone other than your employer caused your injury, you may have a separate lawsuit. Also, if your employer was willfully uninsured, there may be special rights. Your attorney will explain when lawsuits are possible
What kind of medical care am I entitled to? You are entitled to all treatment reasonably required to cure or relieve the effects of the work-injury — at no cost to you. That covers doctor visits, surgery, therapy, medications, prosthetics, and more, so long as the treatment is work-related. There are rules and network restrictions, but if your injury is accepted, your employer’s insurance must arrange the care
What if my employer insists I work after I got injured? If a doctor has restricted your work and your employer asks you to perform tasks that violate those restrictions or cause pain, you should notify your doctor and employer in writing. Keep a record of these requests. If your employer ignores your injury or forces work against your doctor’s restrictions, let your attorney know — there may be additional protections for you
Should I report the injury to my employer? YYes — report it as soon as possible. Tell your supervisor or employer in writing (or as required) what happened, when and where it occurred, and ask for the required claim form (DWC-1 in California). Make a note of the date, time, and with whom you spoke. If they don’t give you the form or ignore your report, you should still seek medical treatment and notify your attorney immediately. Failure to notify may harm your claim
Can I stay at my job if I open a claim?
Yes. Filing a workers’ compensation claim does not mean you must leave your job. If your doctor allows you to return to work (full or modified duty), you can stay. If you cannot do your usual job, you may still receive benefits even if you try to return in some capacity.
- What if I worked at a job that pays me cash?
Even if you were paid in cash, you may still be entitled to workers’ compensation. The key is proving you were employed and injured on the job. Pay stubs, canceled checks, deposit slips, time cards, or other documentation can help. Don’t assume a “cash job” means you’re uncovered.
What if I am working illegally or are a non-resident?
Even if you are undocumented or a non-resident, you generally still have rights under California’s workers’ compensation laws: you may still open a claim. The main issue is proving you were employed and injured on the job. Documentation and legal advice matter.
If you are truly a volunteer (not an employee with wages or expectation of compensation) and you’re injured while volunteering, you typically do not have a workers’ compensation claim under California law. Each case depends on how the relationship is legally defined — you should check with an attorney.
If a work-related injury or illness causes death, your dependents may be entitled to death benefits under workers’ compensation. The family should act promptly — specific time limits apply. An attorney can help your family preserve their rights.
Is workers compensation only for physical injuries? No. Workers’ compensation can cover physical injuries and occupational illnesses, stress or psychological harm, exposure to toxic substances (mold, chemicals, blood-borne diseases), hearing loss, respiratory problems, and other work-related conditions. If your job exposed you to harm that developed over time, you may have a valid claim
What if my employer did something intentionally or grossly negligent to me? I
If your employer intentionally harmed you or acted with gross negligence, you may have a “serious and willful” claim on top of your workers’ compensation benefits. These claims allow for higher benefits (and sometimes a lawsuit) — you should talk with an experienced attorney about whether your situation qualifies.
What if my employer did nothing wrong, but I was injured?
If your employer intentionally harmed you or acted with gross negligence, you may have a “serious and willful” claim on top of your workers’ compensation benefits. These claims allow for higher benefits (and sometimes a lawsuit) — you should talk with an experienced attorney about whether your situation qualifies.
What if I was partially at fault? That’s okay. California’s workers’ compensation system is a no-fault system, meaning you don’t have to prove someone else was responsible, and your own mistake doesn’t necessarily bar your claim. You may still qualify for benefits even if you share some fault
What if I have a previous injury? Having had a prior injury doesn’t necessarily stop you from filing a new claim. You should inform your doctor and your attorney about the prior injury. The insurance company may try to reduce (“apportion”) the new claim by attributing part of your disability to the old one. A lawyer can help protect your rights in this situation.
What if I have a criminal record?
Yes — you still may have a workers’ compensation claim. A criminal record does not automatically disqualify you from filing a claim or receiving benefits. Injury and employment facts matter most.
Are all on the job injuries covered by workers’ compensation?
If you’re an employee and you’re injured during your job duties, then yes — workers’ compensation is designed to cover that. But there are details to check: Was the injury job-related? Were you acting within the scope of employment? Did you report it properly? Contact us and we can review your specific facts.
If you or a family member have been hurt on the job, you don’t have to face this alone. The workers’ compensation system can be confusing — you deserve a lawyer who will walk you through it clearly and confidently. Feel free to call our office and we’ll talk through your situation.
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