In general, worker’s compensation does not cover pre-existing conditions. If you have a medical condition prior to suffering your work-related injury, the workers’ compensation program in California will not provide any payments or coverage to treat the original condition—just the work-related accident. According to the Department of Industrial Relations (DIR), you could have medical care benefits denied if the treatment is for pre-existing conditions.
However, rarely are things so straightforward. You could have a work-related incident that aggravates a pre-existing condition. Many people have a medical condition or health concern that they manage, even if it has nothing to do with the work-related injury. Pre-existing conditions can make the process of successfully filing a workers’ compensation claim more complicated and complex. You can work with a workers’ compensation lawyer to help you navigate the process.
Types of Worker’s Compensation Benefits
There are four types of worker’s compensation benefits recognized by California’s workers’ compensation program:
- Medical benefits: Medical benefits cover any bills associated with hospitalizations, doctor’s visits, surgeries, and physical therapy.
- Disability benefits: This category covers compensation while you cannot fully or partially complete your work duties. Temporary and permanent disability benefits are available.
- Career support benefits: These benefits can help you transition to a new career because your injury leaves you unable to perform the tasks associated with your old job. You could receive benefits for career training, professional licensing, and the cost of computer equipment, if necessary.
- Death benefits: If a work-related accident caused the death of your loved one, you might qualify for death benefits under the California worker’s compensation program.
This list highlights the major components of the state’s workers’ compensation program. However, it is not exhaustive. Under each umbrella of the plan, there are other types of compensation and coverage options available.
If you have any questions about whether the program covers an expense that you incurred because of your work-related injury, you can discuss your concerns with a workers’ compensation lawyer who can give you more personalized advice based on your injuries and long-term prognosis.
Statute of Limitations
Workers’ compensation claims have a set amount of time during which you must file your claim. Ideally, you would notify your employer immediately after you suffer your injury and file any applicable forms that day. California Labor Code (LAB) §5400 states that you have 30 days from the date of the incident or when you discovered the injury to notify your employer and fill out relevant paperwork documenting the injuries.
According to LAB §5405, you have up to one year to file a workers’ compensation claim. Should you wait longer than this period to get started, you will likely not receive workers’ compensation benefits related to this injury. It is always a good idea to begin the process as soon as possible.
Workers’ Compensation Laws in California
In California, all employers must pay for workers’ compensation coverage, even if they only have a single employee. This requirement differs from other states that mandate an employer to have a certain number of employees before they need to enroll in workers’ compensation coverage. California’s plan covers most work-related injuries, with exceptions outlined by LAB §3600, including:
- The employee did not intentionally inflict the injury.
- The employee did not start an altercation.
- The employee was not intoxicated when they suffered the injury.
Your employer or the state’s workers’ compensation program might offer you a lump-sum settlement as opposed to ongoing biweekly payments. In some cases, this arrangement can work out better for you than if you received regular benefits. However, this will depend on your situation and varies based on each case.
If you accept a settlement, you will likely not have any future claim to workers’ compensation payments related to your injury. You will not have the opportunity to negotiate a better deal later if your recovery lasts longer than you thought it would or racks up more medical expenses than you expected.
You might want to have a workers’ compensation lawyer review any settlement offers and the associated fine print before you accept it. They can determine if the amount adequately addresses your needs or the offer contains unacceptable terms, and they can negotiate for a better deal on your behalf.
Contact Pintas & Mullins Law Firm to Schedule a Consultation
Because worker’s compensation does not cover pre-existing conditions, it could complicate your workers’ compensation claim for legitimate work-related injuries if you suffer from one. You might benefit from working with a workers’ compensation lawyer to help you through the process. Contact Pintas & Mullins Law Firm today at (800) 529-9122 to schedule a free consultation with a member of our team to discuss your claim and see how we can help you.