Filing a workers' comp claim in California means reporting the injury to your employer, ideally in writing within 30 days, and then completing and returning the DWC-1 claim form your employer must give you. The employer sends it to its insurer, which has 90 days to accept or deny. If the insurer does not deny within 90 days, the law presumes the injury covered.
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| Who can file | Most California employees, whatever their immigration status |
|---|---|
| Report to your employer | Within 30 days of the injury (Labor Code § 5400) |
| Claim form | DWC-1, provided by your employer within one working day of notice |
| Insurer's decision | 90 days, or the injury is presumed covered (§ 5402) |
| Filing with the WCAB | Generally within one year (§ 5405) |
| Attorney fee | Typically 15%, approved by the WCAB, paid from the award |
Who can file a workers’ comp claim in California?
Any employee injured because of their work can file a workers’ comp claim in California. It does not matter whether the injury came from one accident or built up over time. Nor does the claim depend on who was at fault, how long you have worked there, or whether you work full time.
Labor Code § 3600 sets the test: the injury must arise out of and in the course of your employment. That covers injuries on the premises, on the road for work, and on errands your employer asked you to run. Your commute to and from work is usually not covered, though there are exceptions.
- Part-time and seasonal workers Covered from the first day, on the same terms as full-time staff.
- Workers without immigration status Covered. Labor Code § 3351 includes employees “whether lawfully or unlawfully employed.”
- Workers paid in cash or called contractors Often covered. The label your employer uses does not decide whether you are an employee under California law.
- Workers whose employer has no insurance Still able to claim. California’s Uninsured Employers Benefits Trust Fund exists for that situation, and the process is different.
How do you report a work injury to your employer?
You report a work injury by telling your supervisor or employer that you got hurt at work. Labor Code § 5400 gives you 30 days from the injury to do it. Written notice is safest because it creates a dated record.
A short email or text to your supervisor is enough. Say what happened, when and where, and which part of your body hurts. Keep a copy. If you report in person, write down the date, the person you spoke to and what you said.
Report even when the injury seems minor. A back strain that feels manageable on Monday can keep you off work by Friday. Besides, a claim reported promptly is much harder to challenge than one reported weeks later.
What is the DWC-1 claim form?
The DWC-1 is the official California workers’ compensation claim form, issued by the Division of Workers’ Compensation. Returning a completed DWC-1 to your employer is what formally opens the claim and starts the insurer’s deadlines.
Under Labor Code § 5401, your employer must give you the form within one working day of learning of the injury. A notice explaining your potential benefits comes with it. The form has an employee section and an employer section.
- You complete the employee section Give your name, contact details, and the date and place of the injury. Then describe plainly what happened and which body parts the injury affects.
- You return it to your employer Hand it in or mail it, and keep a copy showing the date you delivered it.
- The employer completes its section It dates the form, gives you a copy, and sends it to its insurer or claims administrator.
- The insurer opens a file You should receive a letter with a claim number and the name of the adjuster handling it.
List every body part that hurts, not only the worst one. Adding a body part later is possible, but it invites questions about whether the new complaint came from the same injury.
What happens after you file the claim form?
Once you file a workers’ comp claim on the DWC-1, the insurer has up to 90 days to accept or deny it. Meanwhile, it must authorize limited medical treatment while it decides. If it does not deny the claim within 90 days, Labor Code § 5402 presumes that workers’ compensation covers the injury.
During those 90 days, the insurer may take a recorded statement, request your medical records and speak to coworkers. It may also send you a letter saying it is delaying a decision while it investigates. A delay is not a denial, but the clock keeps running.
- Accepted The insurer pays for treatment and, if you are off work, temporary disability. Those payments are generally two-thirds of your average weekly wage within state limits.
- Accepted in part The insurer accepts some body parts and disputes others. You can pursue the disputed parts through the same claim.
- Denied The insurer sends a written denial with its reasons. That is its position, not the last word. See denied workers’ comp claims.
Where do you get medical treatment for a work injury?
Most injured workers in California receive treatment through their employer’s Medical Provider Network (MPN), a list of doctors the insurer has approved. The doctor who manages your care is your primary treating physician, and their reports drive your benefits.
After the first visit, you can usually choose a different doctor within the network. Before the injury, you may have given your employer a written predesignation of your personal physician. If so, and your employer offers group health coverage, you may be able to treat with that doctor instead.
Your doctor’s treatment requests go through utilization review (UR), where the insurer decides whether to approve them. If UR denies or modifies a request, you can ask for independent medical review (IMR) through the state. The UR decision letter states the deadline and includes the form, so keep it.
What are the deadlines for a workers’ comp claim?
When you file a workers’ comp claim in California, three main deadlines apply. You have 30 days to report to your employer, and the insurer has 90 days to decide. You then generally have one year to file with the Workers’ Compensation Appeals Board (WCAB).
| Deadline | Whose deadline | Source |
|---|---|---|
| 30 days to notify the employer | Yours | Labor Code § 5400 |
| One working day to provide the DWC-1 | Employer’s | Labor Code § 5401 |
| 90 days to accept or deny | Insurer’s | Labor Code § 5402 |
| Generally one year to file with the WCAB | Yours | Labor Code § 5405 |
Under § 5405, the one-year period generally runs from the date of injury, or from the last date the insurer paid benefits or provided treatment. For cumulative trauma, Labor Code § 5412 sets the date of injury as when you first suffered disability and knew, or reasonably should have known, that work caused it.
What should you expect from the insurance adjuster?
The adjuster works for the insurer, not for you or your employer. Their job is to decide what the insurer owes. Expect a phone call within the first few weeks, often with a request for a recorded statement about the injury and your medical history.
A recorded statement becomes part of the file. Later, the insurer can compare it with what you told your doctor and your employer. Adjusters often ask about earlier injuries, activities outside work and prior claims. Honest, consistent answers matter more than long ones.
Once you have an attorney, the adjuster communicates through the attorney’s office. An attorney can tell you whether a statement is required in your situation and can be present when one is taken. The page on how the process works explains what the firm handles once you sign.
What mistakes can weaken a workers’ comp claim?
Most weak claims lose their strength in the first few weeks, by late reporting, incomplete descriptions or gaps in treatment. None of these ends a claim on its own, but each gives the insurer a reason to question it.
- Waiting to see if it gets better Delay makes the insurer ask whether something outside work caused the injury.
- Leaving out a body part A shoulder that hurts along with the back belongs on the form from the start.
- Missing appointments Gaps in treatment read as recovery, whether or not you have recovered.
- Different versions of events What you tell your supervisor, the doctor and the adjuster should match. Small inconsistencies get noticed.
- Filing only after a termination notice Labor Code § 3600(a)(10) limits claims first filed after notice of termination or layoff, subject to exceptions. Our guide to being fired while on workers’ comp in California covers what to do if you lose your job around the time of a claim.
Sometimes someone other than your employer caused the injury, such as a driver or an equipment maker. You may then also have a separate lawsuit; see third-party claims. If the insurer later disputes the medical findings, the QME process decides them.
What does it cost to have a lawyer file your claim?
With this firm, the attorney’s fee in a workers’ compensation case is typically around 15% of the award. A workers’ compensation judge approves it under Labor Code § 4906, and it is paid from the award, so you pay nothing up front. The fees and consultations page sets out how the firm charges for each practice line. For the rest of the process, see the overview of workers’ compensation in California.
Your first consultation is free and takes about thirty minutes, in person in Glendale, by phone or by video.