California Workers' Compensation
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Don't make these mistakes that could lead to employee lawsuits.
What is worker’s compensation (worker’s comp)? Workers' compensation insurance is a no-fault insurance system. The workers' compensation program is a trade-off that exchanges your limited absolute liability for work-related injuries and illnesses for your employees' common law right to sue you for damages. If your employee is injured on the job, your workers' compensation insurance will provide benefits such as temporary disability, medical expenses and permanent disability award, if appropriate, based on the long-term effects of the injury.
- Not carrying workers' compensation insurance or allowing it to lapse.
Acquire Insurance Coverage for Your Needs
Carrying workers' compensation insurance is a basic requirement of being an employer in California. You must have workers' compensation coverage at all times while your business is in operation. If you fail to provide coverage, and an injury occurs, you will have to pay the employee's medical costs, and risk additional liability in the form of penalties and the possibility of lawsuits.
Post All Legally Required Forms, Posters and Notices
All current employees must easily see the California Workers' Compensation poster that contains information about your insurance representative, medical emergency telephone numbers and the claims administration contact information. All new employees must be handed the California Workers' Compensation pamphlet. This notice describes the rights and obligations of employers and employees and includes forms for pre-designating a health care provider. There are other claim and reporting forms. View the Workers' Compensation Checklist for more detail as well as Required Posters and Notices. Visit our online store to purchase Workers' Compensation pamphlets.
Know How Workers' Compensation in California Works
There is a difference between first aid and medical care. You have minimal reporting obligations if the injured worker loses no time from work beyond the date of the injury and the treatment falls within the definition of first aid. Classification of cases as first aid saves you money because they do not affect your insurance premiums. For serious injuries, send the employee for medical care and call their emergency contact immediately.
In most cases, you may designate the treating physician for at least the first 30 days following an injury. If your insurer has selected one or more Medical Provider Networks to treat your employee's work-related injuries, you must provide additional information to your employees.
You must provide certain information in a timely manner:
- You must report a death or serious injury requiring more than 24 hours of hospitalization or loss or serious disfigurement of a body part to Cal/OSHA within eight hours.
- You must provide claim forms within one working day of receiving notice of the injury to the employee.
There are reporting and recordkeeping obligations for all injuries. Be sure your supervisors are aware of your company's obligations to care for injured workers, provide claim forms and document injuries.
Stay in Touch with Your Employee
This seems obvious, but it is a critical step in controlling the cost of your claims. Employees who feel they understand the process, and feel valued as a member of your workforce, are more likely to keep their medical appointments, follow medical instructions, cooperate with the claims adjuster and have a desire to return to either their regular job or a slightly modified one, customized to their needs. Call the doctor and stay informed of the employee's status.
Make sure the insurance carrier mails the first disability payment or gives the employee written notice of their benefit status, and check that subsequent disability benefits are paid on time. If you have reason to doubt the validity of the claim, you must notify your claims adjuster immediately. A claim may be delayed for as many as 90 days while its validity is determined. During this time, temporary disability benefits may be withheld, but employees must receive certain notices regarding the delay and the reasons for it. Your company can incur penalties if the worker is not receiving timely benefits for a legitimate job-related injury.
Review the Doctor's First Report and Investigate the Accident
No company wants a repeat incident, so investigate the accident and determine the exact cause of injury. Interview any coworkers or witnesses and inspect the workplace environment to identify corrective actions that will prevent recurrence. Use these notes in your Log 300 records to satisfy obligations under your Injury and Illness Prevention Program. The treating physician has five days to deliver the first report of the initial examination. Focus on new opportunities for the employee to return to work and discuss work limitations and potential accommodations with the doctor. The most efficient way to control workers' compensation costs is to get people back to work with a modified duty program.
HRCalifornia members have access to several tools and services that help those who manage human resources to work through workers' compensation issues, including:
Workers' Compensation Claim Form - DWC 1
If an employee suffers a work-related injury or illness, he or she may be entitled to workers' compensation benefits. Give this form to the employee and have him/her complete the "Employee" section and then return the form to you.
Workers' Compensation Benefits for Victims of Workplace Violence
Use this sample notice when an employee is a victim of a crime at your workplace. You must give the employee written notification of his or her eligibility for workers' compensation benefits for resulting injuries, including psychiatric injuries.