The exact order of events and benefits involved when an employee sustains a work-related injury can vary from claim to claim, however, the typical timeline of a Workers' Compensation claim is described below.

1. A claim is officially triggered by completing and submitting a DWC1 form to your supervisor.
2. Once a claim is received, Workers’ Compensation has 14 calendar days to decide to accept or delay the claim. During this period, you should be contacted by your Claims Representative and be evaluated by an approved medical provider (Medical Provider Network or pre-designated physician).  You will receive an initial claim set-up packet with information about our Medical Provider Network as well as a pharmacy card for prescriptions.  If you are not contacted by your Claims Representative, please contact Workers’ Compensation at 619-236-6395.
3. Depending on the facts of the injury, if your claim is delayed, Workers’ Compensation has 90 days (for most of the claims) and 75 days (for certain presumptions) from the day your claim was filed to complete an investigation. You may be asked to supply prior medical records or other relevant information that will help determine your eligibility for benefits. It is crucial that you participate in the investigation to expedite the process. 
   
   1. During the delay period, you are not eligible for wage replacement benefits (Temporary Disability, Industrial Leave or 4850). Workers’ Compensation is only obligated to cover up to $10,000 in medical treatment during the delay period and will also compensate for medical mileage during the delay period.  
   2. If your claim is later accepted, your annual leave will be reimbursed or you may receive a check from Workers’ Compensation depending on how your lost time was covered.
4. Depending on the facts of the injury, if your claim is denied, you will receive a letter explaining the reasons for our denial and your appeal rights.  
5. If your claim is accepted, Workers’ Compensation will monitor your medical care and administer benefits appropriately until you are discharged from care and/or declared permanent and stationary. 
   
   1. Once you are discharged from care and/or declared permanent and stationary, please inform your Claims Representative and they will determine if you are eligible for any further benefits. 
   2. If you are determined to be eligible for additional benefits, you and your Claims Representative will complete the appropriate paperwork to finalize and resolve your claim.