Some Worker Compensation Reminders

First, I would like to start with a reminder. In the state of California, if you have employees, you must carry worker compensation coverage. Even if you only have one part-time worker, this is still required. This coverage protects you and your employees. The district attorney’s office is actively inspecting businesses to ensure this coverage is in place and fines are being levied. If you have a worker compensation policy, DO NOT let it lapse! The insurance companies have been hit with a record amount of claims in the dry cleaning code. As a result, the premiums are raising and the companies are tightening their belts. If you have a lapse in coverage, many insurance companies will not write your coverage. If they do, it will be at a much higher premium.

Workers compensation is the nation’s oldest social insurance program according to the California Department of Industrial Relations. It was adopted by most states during the 1920s. The worker compensation system is based on a trade off between employers and employees. Employees are entitled to receive prompt effective medical treatment for on the job injuries no matter who is at fault and in return, the employees are prevented from suing employers over those injuries.

Workers comp insurance provides six basic benefits: medical care, temporary disability benefits, permanent disability benefits, supplemental job displacement benefits/ vocational rehabilitation and death benefits. Most workers comp claims are resolved without any problems. This is why both you and your employee must know what steps to take in the event of an injury.

First, The California Division of Worker Compensation has put new regulations in effect recently that require the use of new forms. The DWC monitors the administration of worker compensation claims. Its mission is to minimize the adverse impact of work-related injuries on California employees. State form DWC-7 “Notice to Employees – Injuries Caused By Work” must be posted where your employees can see it. The same form is available in Spanish as well. This form informs the employe of their responsibilities and what they should do in the event of an injury.

All new hired employees must be given the pamphlet Facts About Workers Comp. This pamphlet informs the employee of their rights to worker compensation benefits and how to obtain them.

In the event of an injury, you must provide the updated State form DWC-1 Employee Claim Form & Notice Of Potential Elibility to employees. (Please note: any of the above mentioned forms can be obtained from your insurance company or on the website www.dir.ca.gov/dwc). It is important to report the injury to your insurance company immediately. Even if the injury seems minor or you think if may be a fraud, the insurance company needs to know quickly. Give the insurance company all of the information you have. If there are witnesses to the injury, it is important to take a statement from the witness. Keep in contact with the claims adjustor assigned to your claim. Communication is the key. These claims will affect your future premiums so you need to keep aware of how the claim is being handled. If you need help, contact your agent. He/she will be able to assist you.

Those of you who have Worker Compensation Coverage are familiar with Medical Provider Networks (MPN). These networks of doctors are similar to Health Maintenance Organizations (HMO). Your insurance company should have provided you with a list of the preferred doctors or facilities. If you don’t have the MPN list, contact your agent or company to obtain it. It is important to have the MPN list, available when the injury occurs. If your employee has not pre-designated a doctor, they must go to one of the approved providers. This is very important to keep the claims cost in check. The Worker Compensation Insurance Companies are working on your behalf. So please be helpful in providing them what they need.