What do I need to do when my employee is injured and needs workers' comp?

  • #Ask Huck
  • Claims

It’s stressful when a member of your team goes down on the job. But here’s exactly what you need to do in the state of California to get through the situation.

  • Make sure your employee gets immediate medical treatment, if necessary
  • If it’s a serious injury, report it to the California Division of Occupational Safety and Health
  • Give the employee a DWC-1 claim form
  • Fill out form 5020
  • Complete the employer portion of the DWC-1 form
  • Authorize up to $10,000 of medical treatment
  • Complete a Wage Statement form, if your employee is unable to work
  • Give your employee a complete Medical Provider Network notification, if applicableProvide light work, if necessary

Okay, let’s explain a little more.

Here’s what to do as soon as you hear about the accident.

Make sure your employee gets medical treatment.

It might seem obvious, but we have to say it: you should make sure that your employee gets the medical attention they need. If it’s an emergency situation, make sure they go to the nearest emergency room immediately. It’s their right.

(Also, if your employee predesignated a personal physician before the accident, know that they have the right to see this person for their injury.

If the injury is serious, pick up the phone.

If your employee suffers a major injury, you need to call the nearest office of the California Division of Occupational Safety and Health. You can find contact information for your nearest office here.

What constitutes a major injury? Basically, a serious injury is anything that requires more than 24 hours of hospitalization. When in doubt, go ahead and call. Better safe than sorry.

Provide the injured employee with a DWC 1 claim form.

You’re required by law to provide your employee with a special form called a Workers’ Compensation Claim Form. It’s also known as DWC 1 and you can download a copy here. (If you have workers’ comp with Huckleberry, you can always find a copy of this form in your online portal.)

Technically, you have one working day to get this done, but you’ll want to do it immediately and get it out of the way.

Fill out and submit the Employer’s Report of Occupational Injury or Illness.

This is also known as form 5020. Basically, it’s a place for you to explain everything you know about the accident. To fill it out, you’ll need to know the details of what happened, where the incident occurred, any equipment that was involved, etc.

If there’s anything you don’t know, that’s okay. Gather all the information you can and do your best. But remember that the state of California requires that you submit this form within 5 days of hearing about the injury. (And we say the sooner, the better. Get the details down while they’re fresh on your mind.)

Here’s what to do in the days following the accident:

Fill out your portion of the employee’s claim form.

You need to wait on the injured employee (or their representative) to fill out their portion of the DWC-1 form. After they do, though, it’s up to you to complete the “employer section.” It’s a pretty simple form. Just be sure to have your workers’ comp policy number ready.

Submit the DWC-1 form to your insurer.

In the state of California, you’ll need to provide copies of the completed form to both your employee (or their representative) and to your insurer within one working day.

Be sure to keep a copy for yourself. You’ll want a paper trail for the entire process.

If your employee is unable to work, complete a Wage Statement form.

This is how you tell your insurer exactly what your employee was making before their injury. It’s how they’ll calculate the benefits your employee should receive.

Take care of the Medical Provider Network side, if appropriate.

If your employees are covered by a Medical Provider Network (often shortened to MPN), you need to give the injured employee a complete MPN employee notification. You’ll also want to follow up to ensure an MPN physician performs an initial medical evaluation, if the employee didn’t predesignate a physician.

Read more about Medical Provider Networks in California here.

Authorize up to $10,000 in appropriate medical treatment.

You need to authorize medical treatment within one day of receiving the the completed DWC-1 claim form. That way, your employee can get the care they need while they’re waiting for the claim to be reviewed.

Provide lighter work duties, if appropriate.

If your employee can’t do their normal job right now but is still well enough to work, you can assign them tasks that won’t cause pain or aggravate their injury.

Keep in mind, though, that the ultimate decision regarding whether an employee is able to work is up to a medical physician—not you. Soon after the injury, the employee’s treating doctor will do an examination and give a report on your employee’s condition. This report will let you know whether your employee will be able to continue working or not, and whether there will be any special conditions.

The doctor may tell you an employee is able to work, but with certain work restrictions—for example, the worker is unable to pick up heavy objects. Then, you have to provide a workplace that meets those restrictions. (If you can’t swing the restrictions, then you can’t require your employee to work.)

Stay in touch with your employee and your insurer.

Whatever happens, you’ll want to keep the lines of communication open with your employee and their family.

And don’t forget to keep your insurer in the loop, too. They can provide guidance on what’s going on and let you know if you need to do anything else.

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Disclaimer

All content on this page is for general informational purposes only and does not apply to any specific case, is not legal, tax or insurance advice and should not be relied upon. If you have any questions about the situation for your small business or the latest information in your state, you should contact an attorney for legal advice, an insurance agent or broker, and/or your state's labor or industry agency, board, commission or department. Please note that the information provided on this page may change at any time as a result of legislative action, court decisions or rules adopted or amended by any state or the federal government.