Worker Comp FAQ

1. What is workers' compensation or work comp in California?

Workers' compensation is the state-mandated and regulated insurance services that provide compensation to workers and employees who may suffer job-related injuries and illnesses. Although the federal government does administer a workers' compensation program for federal and other various employees, every individual state has its own programs and legal rules for workers' compensation. For up-to-date information on work comp in California, contact your state's workers' compensation office. 

Please click the following link to the CA office (California State Workers' Compensation Officials page from the United States Department of Labor's website.)

Specifically, any employee in San Francisco who has a work-related injury is entitled to receive workers' compensation benefits regardless of who is the faulty party -- whether it was the employee's fault , the employer's fault, a coworker mistake, a customer's actions, or any other third party issue. The converse is that, in exchange for these workers' compensation guaranteed benefits, the employee is usually forbidden from suing the employer in court for any damages for those illnesses or injuries.

If you believe your injury is work related please contact our nearest SFMMG office immediately to see our physicians.

2. Are all on-the-job injuries covered by workers' compensation in San Francisco?

Workers' compensation in San Francisco, California will covers most, however not all, on-the-job illnesses or injuries. The work comp system has been designed to provide injured workers benefits, regardless if an injury was caused by the employee's or employer's carelessness. However, there are various limits. Generally, injuries involving intoxicated employees or if they are using illegal drugs may not covered by workers' compensation.

Workers' Compensation coverage is San Francisco may also be denied in situations involving:

• certain self-inflicted illnesses or injuries
• Injuries caused by a person who starts an altercation or fight
• Injuries or illnesses suffered if the employee was not on the job
• injuries or illnesses happened if the worker was involved in a serious crime at the time
• injuries or illnesses occurred when an employee's conduct violated company policy.

3. Does workers' compensation cover only injuries or will it cover long-term problems or illnesses?

An worker injuries in California need not be caused by only an accident -- such as a fall from a truck or staircase -- to be covered by California work compensation system. Many injured workers can receive compensation for their on-the-job injuries that may be caused by overuse and misuse over a certain period of time -- an example, repetitive stress injuries such as carpal tunnel syndrome or lumbar back problems. Injured workers in San Francisco can be compensated for various illnesses and diseases that may be due to gradual result of work conditions -- for example, lung disease, stress-related digestive problems and heart conditions.

If you believe your injury is work related please contact our nearest SFMMG office immediately to see our physicians.

4. Do I have to be injured at my workplace to be covered by workers' compensation?

No. In California, as long as your illness or injury is job-related, it's going to be covered. An example, you will be covered for your injury if you were injured while traveling for business, participating in a work-related errand, or attending required business-related social activities.

5. What kind of Work Comp benefits will I receive in California?

The workers' comp system in San Francisco will provide you with replacement income, certain medical expenses, and in various instances, vocational or rehabilitation benefits -- meaning, on-the-job training, new schooling, or job placement assistance. It is important to note that the benefits that will be paid through the California workers' compensation system are very often relatively modest.

If you are temporarily unable to continue working, you may receive two-thirds of your pervasive wage up to a certain predetermined ceiling. However since these payments are completely tax-free, receiving decent wages before your injury will result in reasonable benefits in California.

If you are permanently unable to continue the work detail you were doing before the injury, or unable to do any work, you could be eligible for long-term or even a lump-sum package of benefits from the state of California. Obviously, the amount of the lump sum is dependent on the nature or extent of your illness and injuries.

If you anticipate a permanent work disability, contact our nearest SFMMG office immediately as these benefits are rather complex and may take a while to process.

6. Can I be treated by my own doctor and, if not, can I trust a doctor provided by my employer?

In California, the workers compensation system allows you to see any doctor of your choice. Furthermore, SFMMG doctors have been involved in the Work Comp system for years and will be experienced at handling all aspect of your case . Since you have a right to see your own doctor, you should make this request in writing to see SFMMG doctors before the injury occurs. However, it is more common for injured workers to be referred to a doctor recruited and who is paid for by their employers.

7. Can I ever sue my employer in court over a work-related injury?

Yes. If you sustain an injury because of reckless or intentional acts on the part of your employer, you can bypass the workers' compensation system and sue your employer in court for a full range of damages, including punitive damages, pain and suffering, and mental anguish.


8. What if my employer tells me not to file a workers' compensation claim or threatens to fire me if I do?

In California, it is a violation of the workers' compensation laws to retaliate against an employee for filing a workers' compensation claim. If this happens, immediately report it to your local workers' compensation office.

If you believe your injury is work related please contact our nearest SFMMG office immediately to see our physicians.