r/CaliforniaWorkComp

Hi everyone, I'm the mod here. Thought I'd do this since the sub just hit its one year mark and we've grown past 350 members.

Quick background: I spent about 15 years on the defense side of California workers' comp, eventually as an equity partner at a large statewide defense firm. My job was defending insurance companies and employers against injury claims, including the big ones, catastrophic injuries, amputations, death cases. I sat in rooms with adjusters, supervisors, claims managers, and vice presidents deciding how your claims would be handled.

A year ago my brother and I left to start our own firm representing injured workers instead. Best decision I've made. We're both Certified S

When I started this sub last summer the goal was simple. A California specific space, run for injured workers, focused on helping injured workers without answers filtered by anyone except those 100% on injured workers side.

Workers' comp is a complicated system and the questions injured workers actually have (how does my QME work, why is my treatment getting denied, what does this letter mean, am I going to be okay) deserve answers from people whose first instinct is to help.

That was the bet. 300 of you later, I think it's working.

Thank you for the questions and the answers.

The threads where someone walks in with a hard question and walks out with a clearer next step are the reason

If you are public safety officer, Police Officer, Fire Fighter, Sheriff, School District Police Officer, University of CA Police Officer there are special rules that apply to you:

1. Full Salary Benefits LC4850 - While Totally Temporarily Disabled, you are entitled to 100% your salary for one year, instead of 2/3.

2. Cancer Presumption LC 3212.1 - Your Cancer is presumed to arise out of work if even having de minimums cancer agent exposure.

3. Heart Injury Presumption LC 3212.2 - Your Heart trouble is presumed to arise out of employment with limited exceptions.

4. Duty Belt Presumption (Police Officers) LC 3213.2 your back injury is presumed to arise out employment due to wearing your du

Just finished reviewing this year’s updates from Sacramento a few important changes for injured workers in California:

(Nothing dramatic and groundbreaking that changes the system in fundamental ways)

• SB 779: New fines for unlicensed contractors faking workers’ comp exemptions.
• SB 230: Airport firefighters now get the same presumptions as other fire agencies.
• AB 1125: Peace officers at State Hospitals now covered for heart and cancer presumptions.
• AB 1293: DWC will create a single QME letter template.
• AB 799: Families of incarcerated firefighters can receive up to $50,000 in death benefits.
• AB 1336: Farmworkers get new heat injury protections.

Full br

To everyone in this community who’s working through an injury: thank you. Your labor has built and sustained our towns, and your recovery deserves the same care and respect.

If you’ve hit a wall with treatment approvals, TTD, MMI, or QME issues, post your question here and the community will try to point you to plain English next steps.

I created this sub to help those injured and counter act a ton of misinformation being posted online. Especially, by those working for insurance companies who may not have your best interests at heart. To all those who have reached out and discussed their issues it’s been an absolute pleasure helping those I can.

If you prefer privacy, you can message me

I asked my manager several times if I could go see a doctor after I was bitten by a dog at work. She never answered. Blew me off on multiple occasions. I filed a work comp claim.

The owners called me to settle and have them write me a check if I “cancelled the work comp claim” I was frightened, not going to lie. Felt harassed. The owners called me. He’s never called me before. I’ve worked here for 3 years.

Now what? Can she fire me..?

Please help. Let me know about your experience. Greatly appreciate you!!

Doctor not listening to you? Are you even seeing a doctor? Perhaps the insurance company only sent you to a Nurse Practitioner or a Physician Assistant? Feeling lost? Not Heard? No IDEA how to change doctors?

Here is how, somewhat easily.

Every Medical Provider Network, ("MPN") must have something called a Medical Access Assistant. Typically, if you access the MPN, on the bottom of the list of all providers, there is a phone number and email for the MAA or Medical Access Assistant.

Their job is to help you switch doctors. (Law then translation below)

In fact, the law states verbatim CCR 9767.5, g) For non-emergency specialist services to treat common injuries experienced by the covere