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San Diego Workers' Compensation · Resources

Frequently Asked Questions

Straight answers to the questions injured workers ask most in San Diego — no legal jargon, no runaround. If your question isn't here, call and ask it directly.

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At a Glance

What Benefits Are You Entitled To?

If your claim is accepted, California law entitles you to five categories of support. These are legal protections, not favors from the insurance company.

Benefit What It Covers Current Rate / Detail
Medical Treatment Doctor visits, hospital stays, and prescriptions tied to your work injury. 100% Covered
Temporary Disability (TD) Income replacement while a doctor confirms you can't work. Up to $1,764.11/week (2026 max)
Permanent Disability (PD) A settlement for lasting physical or mental impairment. Set by your Impairment Rating
Retraining (SJDB) A voucher for education or new job skills if you can't return to your old role. Up to $6,000 voucher
Medical Mileage Reimbursement for travel to and from medical appointments. $0.725 per mile (2026)
Frequently Asked Questions

California Workers' Compensation FAQ (2026 Edition)

Real answers to the questions San Diego workers ask most — about their claim, their rights, and their money.

First Steps & Filing Your Claim

What should I do first after getting hurt at work?

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Report it to your employer right away and get medical care immediately. Your employer has to give you a claim form within 24 hours. Fill it out, keep a copy, and see a doctor before the insurance company writes your story for you.

How long do I have to report a work injury?

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California law gives you 30 days to report a work injury to your employer, in writing. Miss that window, and the insurer can use it to deny your entire claim. If your employer ignores your report or claims you missed the deadline, call us immediately — we know how to fight a late-reporting denial.

How long does a workers' comp claim take in California?

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There's no fixed timeline — a clean claim can resolve in months, a disputed one can take years. The insurer must accept or deny your claim within 90 days of getting your DWC-1. Miss that window on their end, and the claim is presumed accepted.

What is a DWC-1 form, and why does the date on it matter?

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The DWC-1 is the form that starts your case, and your date of injury is what insurers scrutinize hardest. Get the date wrong, and they'll use the inconsistency to deny you. If you don't know your date of injury, you're not going to win your case.

Is my injury still covered if it built up over time instead of one accident?

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Yes — California recognizes cumulative trauma the same as a sudden injury. Carpal tunnel, tendonitis, and chronic back pain from years of repetitive motion are all valid claims. These cases get denied more often on paperwork technicalities, so get your date of injury locked in correctly from day one.

Your Rights After You File

Can I be fired for filing a workers' comp claim?

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No. California law prohibits your employer from firing you for filing a claim. If you're let go shortly after reporting an injury, that timing matters — it can be evidence of illegal retaliation under Labor Code 132a. Get it looked at right away.

What if my employer says my injury isn't work-related?

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That's the most common denial tactic in the system, and it's a dispute, not a final decision. Insurers win these disputes when workers don't document the connection to their job. Get witness statements and medical notes tying the injury to work, then call us before you respond.

Can my employer demote or punish me after I file a claim?

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No — Labor Code 132a protects you from retaliation for filing a workers' comp claim. Punishment can look like a demotion, cut hours, or a sudden bad review. Document every change after you filed, and get it in front of an attorney fast.

My employer is pushing me back to work too soon. What are my rights?

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Your treating doctor decides when you're able to work — not your employer. If you're pressured to return before you're cleared, you can refuse without losing your benefits. Put the pressure in writing if you can, and let us handle the conversation with your employer from here.

What if my employer doesn't have workers' comp insurance?

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You're still covered. California's Uninsured Employers Benefits Trust Fund pays benefits when an employer illegally skips coverage. The state pursues that employer separately. No insurance doesn't mean no claim — it means a different path to the same benefits.

Can I file a workers' comp claim if I'm undocumented?

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Yes. Immigration status does not bar you from workers' compensation benefits in California. The law protects every injured worker, regardless of documentation. Don't let fear about your status stop you from getting the medical care and benefits you're entitled to.

Benefits & Money

What am I entitled to after a workplace injury?

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If your claim is accepted, you're entitled to medical care, wage replacement, and possibly a settlement for lasting impairment — see the benefit table above for exact 2026 rates. These are legal rights the carrier owes you, not favors.

How is temporary disability pay calculated in 2026?

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You get two-thirds of your average gross weekly wage while a doctor confirms you can't work, up to a 2026 maximum of $1,764.11 per week. A second job's wages can raise that number — something carriers rarely mention on their own.

Am I entitled to mileage reimbursement for medical appointments?

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Yes — every mile driven to and from approved medical care is reimbursable at the 2026 rate of $0.725 per mile. It adds up fast over a long claim, and most workers never claim it. We track and collect it for you.

How do permanent disability ratings work?

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A permanent disability rating estimates the lasting impact of your injury and sets your settlement value. Insurers routinely push for a lower rating than the medical evidence supports. I pursue every injured body part and build the rating up to reflect the real impact on your life.

What is the SJDB voucher, and who qualifies?

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The Supplemental Job Displacement Benefit is a voucher for retraining if your injury means you can't return to your old job. It pays for approved education or new job skills. Whether you qualify depends on your disability rating and whether your employer can bring you back to work.

How much is my workers' comp case worth?

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There's no set number — case value depends on your wages, your disability rating, and how the injury affects your future work. Anyone who quotes you a figure before reviewing your medical records is guessing. Get a free case review and we'll walk you through what actually drives your value.

Medical Care & Treatment

Can I choose my own doctor for my workers' comp injury?

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You have the right to choose a treating doctor within your employer's medical provider network. You would think a network doctor is looking out for you — think again. If you're unhappy with your care, we help you find a physician in-network who takes your injury seriously.

What is an MPN, and can I change my treating doctor?

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An MPN is the Medical Provider Network your employer's insurance controls, and in most cases it decides which doctors you can see. The one exception: pre-designating your personal physician in writing before you're hurt. Outside that, we help you switch to an MPN doctor who takes your injury seriously.

What's the difference between a QME and an IME?

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A QME is a state-certified doctor who resolves disputed medical issues in your case. An IME is a doctor the insurance company hires on its own, with no state oversight. Picking the right QME matters — we help select the specialist who best understands your specific injury.

Can my employer make me use my own health insurance for a work injury?

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No. You have an absolute right to medical care through workers' comp for any injury sustained at work. That obligation belongs to your employer's insurance carrier, not your personal health plan. If you're being billed through your own insurance, that's worth a call to us.

Denials & Disputes

What do I do if my workers' comp claim is denied?

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Read the denial letter closely, then call an attorney before you do anything else. A denial is often a strategy, not a final answer — many get reversed once we file an appeal with the Workers' Compensation Appeals Board. Waiting to act is the biggest risk here.

I have a pre-existing condition. Am I still covered?

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Yes — California law covers the aggravation of a pre-existing condition by work activity. The insurance company will try to blame your condition entirely on your medical history. Proving the job made it worse is exactly the kind of fight we take on.

What happens if my claim is delayed or under investigation?

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Insurers get up to 90 days to investigate a claim, but you're not left without care during that wait. California requires the carrier to authorize up to $10,000 in necessary medical treatment while your claim is pending. If they stall past that, we push the claim status immediately and pursue any late-payment penalties you're owed.

What happens at a workers' comp settlement conference or hearing?

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A judge reviews your case and pushes both sides toward a resolution, or sets a trial date if you can't agree. Going in without representation means negotiating against an insurance attorney alone. We prepare your case and speak for you in that room.

2026 California Law Updates

What is SB 294, and what does it mean for me?

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SB 294 requires California employers, as of February 1, 2026, to give every employee a standalone written notice of their workers' comp rights. If your employer skipped that notice, it can become leverage in a disputed claim. Ask us to check if this affects your case.

What is AB 692, and how does it protect me?

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AB 692 makes it illegal, as of January 1, 2026, for an employer to charge you "quit fees" or collect training debt when you leave a job. It doesn't change your workers' comp rights directly. It's one more protection against employers using money to control workers.

Did anything change with QME exams in 2026?

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Yes — new Qualified Medical Evaluator regulations under Section 55.1 took full effect April 1, 2026. They change continuing education and reporting requirements for the doctors who evaluate disputed claims. It's a technical change, but it can affect how your QME report gets challenged.

Working With an Attorney

What does it cost to hire a workers' compensation attorney?

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Hiring us costs you nothing upfront. We work on contingency — no fee unless we win your case, and any fee has to be approved by a workers' comp judge before it's charged. With over $1 billion recovered for injured workers, get a free, confidential case review before you decide anything.

Don't see your question here?

If you trust the insurance company's version of events without checking it against an attorney, you risk losing benefits you're owed. Ask us directly — there's no cost and no obligation, just answers.

Schedule Your Free Case Review

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