Frequently Asked Questions

Workers’ compensation in California provides financial and medical support after a workplace injury, but the exact benefits depend on the details of your case.

These benefits may include:

• Medical treatment for work-related injuries or illnesses
• Temporary disability payments while you are unable to work
• Permanent disability benefits for lasting impairments
• Supplemental job displacement benefits for retraining
• Death benefits if a person dies from their work injuries

In some cases, additional recovery may be available through third-party claims. We identify every available path of recovery to help you pursue the best possible outcome under California law.

A denial does not mean your case is over. Claims may be denied for reasons such as lack of medical evidence, disputes about whether the injury is work-related, or missed deadlines. You have the right to challenge the denial through the California workers’ compensation system. We develop a strategic plan to address the denial and advocate for your claim at each stage.

A Qualified Medical Evaluator (QME) is a state-certified physician who provides an independent medical opinion when there is a dispute in your case. This can significantly impact decisions about your injury, treatment, and benefits. The process includes selecting a QME from a panel and attending an exam. We guide you through this process and help you understand what to expect.

SB 863 is a significant reform law that reshaped California’s workers’ compensation system, particularly in how medical treatment disputes, disability ratings, and case efficiency are handled. It was enacted to reduce delays, control costs, and create a more standardized process, while still preserving access to necessary care and benefits for injured workers.

Some of the most important changes under SB 863 include:

• Introduction of Independent Medical Review (IMR) for resolving medical treatment disputes
• Creation of an Independent Bill Review (IBR) to address disagreements over medical billing
• Increases in permanent disability benefits, along with revised rating formulas
• Expansion of Medical Provider Networks (MPNs), giving employers greater control
• Limitations on certain lien filings and stricter filing requirements

In most cases, your employer or their insurance carrier controls the initial choice of treating physician through a medical provider network (MPN). However, there are exceptions, such as predesignating a personal physician before the injury occurs.

If there is a dispute regarding recommended treatment, California workers’ compensation generally requires treatment requests and most non-exempt medications to go through Utilization Review (UR). If treatment is denied, modified, or delayed through a timely UR decision, the dispute may then proceed to Independent Medical Review (IMR) for further review.

You generally have 30 days to report your injury to your employer. Failing to report within this timeframe can jeopardize your ability to receive benefits. However, certain exceptions may apply depending on when you became aware of the injury, especially in cases involving cumulative trauma. We help ensure that your rights are protected from the start.

In most situations, workers’ compensation is the exclusive remedy for workplace injuries, meaning you cannot file a traditional lawsuit against your employer. However, there are limited exceptions, and you may have a third-party claim if another party contributed to your injury. We assess your situation carefully to identify any additional recovery options that may be available.

The timeline varies depending on the complexity of your case, the severity of your injury, and whether disputes arise. Some cases resolve quickly, while others involving significant injuries or multiple issues may take longer. We focus on streamlining the process wherever possible, using proactive strategies and efficient systems to keep your case moving forward.