California Workers' Compensation Laws

California’s workers‘ compensation system is a no-fault insurance system that requires all employers with at least one employee to carry medical coverage for their employees. Workers’ compensation coverage applies to all work-related injuries and illnesses regardless of fault and must cover all medical costs and expenses, plus a percentage of the employee’s lost wages and benefits.

In exchange for full coverage, injured employees cannot sue their employers if they or the business was responsible for their injuries. California’s workers’ compensation program is managed by the Department of Industrial Relations. Both California employers and employees can get information about workers’ comp insurance at the Division of Workers’ Compensation (DWC) site.

This page reviews the basics of California’s workers’ comp insurance. It’ll teach you what you need to know about eligibility, filing, and appealing a denied claim.

Workers Comp Eligibility

Under the state of California’s workers’ compensation laws, nearly everyone paid to work by another entity or individual is covered by workers’ compensation. Any employer with at least one paid employee must have workers’ comp insurance. The law includes coverage for:

• Full-time and part-time employees
• Minors employed in any position
• Seasonal and migrant workers
• Undocumented immigrants if employed in any position
• Misclassified “independent contractors”
• Inmates and residents of state facilities if working at paid positions within a prison or facility

Employers cover workers’ comp costs.

Who Isn’t Covered by Workers’ Comp?

In general, independent contractors aren’t covered by workers’ compensation insurance. In California, an independent contractor is defined as “a self-employed person or business provider who is hired to do a specific job, where the hiring company controls only the final result and not how the work is done.” As self-employed workers, independent contractors are responsible for their own insurance and taxes. If a business owner misclassifies workers, either deliberately or accidentally, as independent contractors, the workers may have a cause of action against their employer.

Others excluded under California law include:

• Family members employed by other family members
• Volunteers doing charitable work such as those working at nonprofit events
• Individuals working for unpaid compensation such as food or shelter from religious organizations
• Certain day laborers working for less than 52 hours or less than $100 on a one-time basis
• Certain salaried officers or board members who have signed a waiver to be excluded from workers’ compensation

In most cases, those not covered by workers’ compensation are those not considered employees. If injured during the course of the “job,” these workers would have other means of recourse against the company.

Types of California Workers‘ Compensation Benefits

California offers four basic types of workers’ compensation benefits. Keep in mind that workers’ comp is meant to cover medical costs and partial wage replacement only. The goal of workers’ comp is to return you to work as soon as possible after a workplace injury. If you become disabled and can’t work, you’ll need a different form of state insurance coverage. Workers’ comp coverage provides immediate protection for work-related injury and illness until your state and federal benefits take over.

Medical Benefits

Medical benefits cover all medical services “reasonably required” to treat or cure the effects of the workplace injury or illness. This includes but is not limited to:

• Hospital services
• Doctor visits
• Prescriptions and medications (although doctors may prescribe generic or alternative medications)
• Surgery
• Physical therapy
• Travel expenses to and from treating physicians

Medical treatment can be restricted to the insurer’s medical provider network. Medical coverage is indefinite, although in practice it lasts until the worker has recovered or is determined to be unable to return to work.

Temporary Disability Payments

Sometimes called “wage replacement benefits,” these are wages paid while you’re recovering from your work injury or illness. Temporary disability payments are typically calculated at about two-thirds of your wages. You can receive temporary disability for 104 weeks in total.

Permanent Disability Payments

Permanent disability payments are awarded if you can’t recover from an injury and are unable to return to work. The state uses a sequence of complex calculations to determine whether someone is permanently disabled and how much they’ll receive if they can’t work. Part of the disability assessment includes determining if retraining is possible.

Death Benefits

If the individual dies as a result of a work-related cause, their dependents can receive death benefits. Survivors are also entitled to any past-due wages and temporary disability benefits the decedent could have collected.

A total dependent is a surviving spouse, minor children, and incapacitated adult children. A partial dependent is any other family members or household members who relied on the decedent for partial financial support. Dependents may receive:

• Burial expenses up to $10,000
• If one dependent, payouts up to $250,000
• If two dependents, payouts up to $290,000
• If three or more, payouts up to $320,000

If the worker dies without dependents, the total death benefit is paid to the Department of Industrial Relations.

Calculating Your Workers’ Compensation Benefits in California

In California, your workers’ comp benefits are determined from your average weekly wage. This number is calculated by adding up your gross monthly earnings for the previous 12 months (before taxes) and dividing by 52. Your monthly earnings are based on all sources of income, including overtime, tips, bonuses, and side jobs.

Workers’ comp pays two-thirds of your average weekly wage for temporary disability payments, with minimum and maximum payments. The lowest amount you can receive per week in 2026 is $264.61. The maximum is $1764.11. You can receive this amount for 104 weeks or until your permanent disability benefits begin.

The compensation amount changes annually, subject to a cost-of-living adjustment (COLA). Mileage reimbursement increased to $0.76 cents per mile on July 1, 2026.

Filing a California Workers‘ Compensation Claim

Injured workers should always report their injury, even if the company’s medical personnel treated them. Requirements for filing a claim include telling your employer in writing that you were injured on the job, even if you were seen in your first aid office or taken away in an ambulance.

The following steps and deadlines provide a guide for maximizing your chances of a successful workers’ comp claim. After being hurt, you should:

• Get medical care: If the injury or illness is severe, see a doctor immediately. If your company has on-site medical care, see the nurse or medical technician at work first. Tell the doctor that the injury was work-related, since they must also file documents about your injury.
• Report the injury: After you’ve been treated, it’s time to report what happened. Inform your employer, supervisor, or manager, in writing, within 30 days of the incident.
• Follow all medical instructions: Heed the instructions of the medical professionals who treat you. If an ER doctor tells you to follow up with your primary care physician, you must do so. Get all instructions in writing and send them to your employer, especially if you’re ordered not to work.
• Receive and file your claim: Your employer must send you a workers’ compensation form within one working day and authorize medical treatment (up to $10,000) while a claim is pending. An injury is presumed covered if the claim is not rejected within 90 days. The DWC-1 Claim Form is also available online. Complete the “employee” section, sign it, and return it to your employer. Keep a copy for yourself.

Your employer has 14 days to notify you whether the claim has been accepted or denied. During that time, keep following your doctor’s instructions. Don’t return to work until your physician releases you. The workers’ comp insurer may have you see another doctor to confirm any diagnosis.

Deadlines

Missing deadlines will cause your claim to be denied or delayed. Never wait to file your paperwork. If you can’t do it yourself, have a trusted family member or friend do it for you.

• Notify your employer of a work-related injury or illness within 30 days of the incident. Don’t assume your employer knows about your injury because it occurred on the job. The notification must be in writing.
• Your employer must provide a claim form within one working day of receiving notice. This is why it’s important to alert them of your injury as quickly as possible.
• You have one year from the date of injury or illness to file a claim. If your condition worsens or you need additional treatment, you have five years to reopen a claim.

In most instances, excuses for missing a deadline won’t help.

What if I Miss the Deadlines?

Missing the filing deadlines can permanently bar you from receiving workers’ comp benefits. Failing to notify your employer within 30 days may lead the insurance carrier to deny your claim by saying the injury was not work-related or that the delay prevents a full investigation of your injury. If you miss the one-year deadline to file a claim, the Workers’ Compensation Appeals Board (WCAB) will likely deny the case.

If there are legal reasons for missing the deadline, an attorney may be able to salvage your claim. For instance:

• If your injury or illness was severe enough to prevent you from reporting before the deadline, the delay may be excused
• If your employer failed to provide a claim form, or did not notify you of your rights, the deadline may be extended
• The one-year deadline runs from the day you “knew or reasonably should have known” your injury or illness resulted from an on-the-job incident

Because of these strict deadlines, the employer or claim administrator must authorize appropriate medical treatment within one day of receiving the claim form. The employee may receive up to $10,000 in medical treatment while the insurance company decides whether to approve the employee’s claim. If the claim is not denied within 90 days, the injury is presumed to be covered.

What if My Workers’ Comp Claim Is Denied?

Workers’ comp insurers are no different than any other insurance company. If they can find a way to deny a claim, they will. The best way to avoid this is to have complete, accurate forms and meet all deadlines. However, employers and insurers may still find ways to deny or delay your claim. If that happens, you may have the right to challenge (appeal) the claim. Let’s take a look at what you might run into and how to resolve it.

Common Reasons for Denial

Some of the most common reasons an insurer or employer may try to deny your claim may include:

• Missing the deadlines, failing to notify your employer, or submitting your claim after you were terminated or laid off
• Seeing your own doctor instead of a doctor in the employer’s medical provider network (this is only permitted if you completed a form before becoming injured)
• California law requires workers’ compensation to cover any aggravation of a pre-existing condition, but it must be disclosed before additional injury
• Medical records that do not connect your diagnosis to a work event
• Non-work-related injury, allegations that the injury occurred off the clock, or was due to misconduct, intoxication, or outside work duties.
• Your employer may claim you are not an “employee” but an “independent contractor” and not covered by workers’ compensation

This is not an exhaustive list.

How To Appeal a Denied Claim

If your claim is denied, you’ll receive a formal denial letter stating that the insurer won’t accept your claim. The appeal process has its own deadlines and procedures, and some are very complex. If you didn’t have an attorney prior to the appeal, this is a good time to consider getting one. Some of these steps require giving notice to your employer and the insurance company, so having legal advice is essential.

Step One: Adjudication of Claim

After receiving a denial from the insurance company, you can request an adjudication of claim from the WCAB. This must be done within the one-year statute of limitations of your original injury. If your claim was denied early in the process and you waited to make your appeal, you could be locked out of the process.

Step Two: Request for Reconsideration

If the request for adjudication is denied or the judge denies the claim a second time, you can file a Request for Reconsideration with the WCAB. This is a more complex process. A Petition for Reconsideration must be filed through the WCAB’s electronic adjudication management system (EAMS).

You have twenty days from receiving the final denial or judge’s decision to file the Petition for Reconsideration. Missing that deadline ends your case.

Step Three: Writ of Review

If the Petition for Reconsideration is denied or rejected, contact an attorney to file a Writ of Review. You have 45 days to file a Writ with the California State Appellate Court.

At each stage, you must go to a mandatory settlement conference, where a judge will try to assist both parties in resolving the matter. If the settlement fails, the case goes to trial. The parties will present medical and witness testimony to establish their case. The evidence you need will depend on the nature of the denial.

Get Help With Your California Workers‘ Compensation Claim

California’s workers’ compensation laws are there to protect you, but they’re complicated and require meeting strict deadlines. If you’re hurt on the job and need medical care, your best course of action is having an attorney explain what your legal rights are and what you can expect from the process.

If your claim is denied, you have limited time to work with. A California workers’ compensation attorney can give you the advice you need and the representation in court to get the settlement you deserve after a workplace accident.