My Boss Does Not Have Workers’ Compensation Insurance—Am I Stuck Paying Doctors Bills?

If you get injured or sick at work, you are eligible for medical treatment and disability payments. This is called workers’ compensation. Your boss is legally required to carry workers’ compensation insurance to protect you and compensate you under qualifying conditions.  

But sometimes an injured worker discovers their employer is not insured. Maybe it was intended to save money, or maybe there was a mistaken lapse in coverage. But in either case, it leaves the injured worker without the insurance that should pay their compensation and medical bills.

What should you do if you find yourself in this situation?

Can I Still File a Claim for Workers' Comp Benefits if My Employer Doesn't Have Insurance?

Yes, immediately file an application for benefits against your employer with the Workers’ Compensation Appeals Board.

Many times, an uninsured employer will admit to not having insurance from the beginning of your claim. But if there is an actual question of whether insurance coverage exists, a special unit in the workers’ compensation system gets involved to investigate.

Even if your employer is found to be uninsured, the Workers’ Compensation Appeals Board can still allow you to pursue your claim and issue you an award if it finds your injuries are eligible for benefits.

Your Options if Employer Doesn't Have Workers Comp Insurance if in California

You have several options for obtaining money from your award to actually receive your benefits against an uninsured employer. It is always best to consult with a workers’ compensation attorney to help you determine the best option for you. However, in most cases, the easiest way to realize your benefits is by getting the Uninsured Employers Benefits Trust Fund involved in your claim.

Confused? Getting the Uninsured Employers Benefits Trust Fund Involved

The Uninsured Employers Benefits Trust Fund pays workers’ compensation awards to injured workers whose employers do not have insurance coverage. It is operated by the state of California and is funded by penalties against uninsured employers and from taxes.

Getting the Fund involved means it can investigate your claim and show up for a trial for your benefits. It does not simply automatically pay your benefits.

If you win your workers’ compensation claim and you properly filed a claim with the Fund, you may then get your benefits.  

The Fund is also a payor of last resort. It is best to get professional advice to determine if this is a proper option for you.

Your Benefits in a Claim Against an Uninsured Employer

You are entitled to compensation benefits from the Fund as if your employer was insured. A workers’ compensation claim entitles you to several benefits. These include:

• Fully paid medical treatment as allowed for by law.
• Disability payments during the claim and after it is settled (Please see our other articles or speak directly with us).
• Job training and education benefits as allowed for by law.

A successful claim against an uninsured employer does not necessarily mean you get fewer benefits. In fact, if your employer was uninsured on purpose, then they owe you 10% more benefits. And your employer is the one who must prove it was not uninsured on purpose.

The Fund is not responsible for paying those extra benefits to you, or any interest or sanctions that your employer may owe you. However, whenever the Fund pays benefits, it seeks reimbursement of the full workers’ compensation award from the uninsured employer. This can be done through a separate lawsuit that does not necessarily involve you. If the Fund recovers the extra 10% penalty and other amounts from your employer, it will pay them to you.

Other Options for Extra Compensation from Your Uninsured Employer

The law says you can only get workers’ compensation benefits when you are injured or get sick at work. That means you cannot sue your boss in court. But if your employer is uninsured, you can file a personal injury lawsuit in court for damages you would not receive as part of your workers’ compensation benefits.

A personal injury claim allows you to collect your full wage loss, compensation for your pain and suffering, and even punitive damages in some cases, among other things. You don’t get a double award, but pursuing both your workers’ compensation claim and your personal injury claim allows you to recover the maximum amount of compensation possible.

A personal injury claim may be easier to win when your employer is uninsured. When you prove your employer lacked workers’ compensation insurance and prove your injury occurred at work, then your boss will be presumed to have negligently caused your injury. Furthermore, your employer cannot argue in court that you were partially at fault for causing your injuries.

Exploring Your Options with a Workers’ Compensation Attorney

Workers’ compensation insurance is supposed to be there for you when you suffer an injury or illness at work. If you need the benefits that you are entitled to by law, do not let your uninsured employer stop you from the recovery you deserve. Hire a workers’ compensation attorney from SoCal Workers Comp. We can help you see a doctor and do all that is legally necessary to get you compensated.

Call or schedule an appointment for a free consultation. If you retain our services, we do not get paid unless you win.

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