Employer Workers’ Compensation Question and Answers
Where do I get workers’ compensation insurance and how much will I pay?
As an employer, you must purchase workers’ comp from either a licensed insurance company or through the State Compensation Insurance Fund. You may also choose to self-insure. Like a consumer, you should shop around for a carrier that meets your needs and provides a fair price.
Your industry classification, company’s past history of work-related injuries and the number of employees all affect your annual premium.
What should I do if my employee gets hurt on the job?You must provide a workers’ comp claim form to them within one working day after the date of their injury. Return a copy of the completed form to the employee within one working day of receipt. If your employees are covered by a Medical Provider Network, help arrange an initial medical evaluation with an MPN doctor.
What can I do if I think my employee’s workers’ comp claim is false?Report your opinion to your workers’ comp claims administrator as soon as possible. Provide facts, witnesses and other evidence that may back up your claims. The California Department of Insurance (CDI) will work with other agencies to investigate possible fraud cases.
Can I get my money back if I paid an employee while they were off work?
You may be reimbursed for benefits you paid if you report the injury to the insurance carrier in a timely fashion and either (1) the insurance carrier has contested liability for the injury and you do not agree, or (2) the insurance carrier has not completed its initial investigation of the injury.
When is a work-related accident not payable under my workers’ comp insurance coverage?
An insurance carrier is not liable for benefits if:
- The employee was injured while under the influence of drugs or alcohol
- The injury was caused by the employee’s own willful attempt to injure themselves
- A person who is not your employee injured your employee
- The injury occurred in a voluntary off-duty recreational, social, or athletic activity
- Horseplay caused the injury
Employee Workers’ Compensation Questions and Answers
I’ve been injured on the job. What should I do next?
First, get emergency treatment if you need it. Notify the health care provider that your injury is work-related. Next, report your injury to your employer within 30 days from the date of the injury.
If your injury or illness developed over time, report it as soon as you learn it was caused by your job. If you fail to notify your employer in time, you lose your right to obtain benefits. Finally, fill out a claim form and give it to your employer.
Can I use my own doctor for a workers’ comp injury?
If your employer provides workers’ comp through a certified health care network, you must select a doctor from the network’s approved provider list. If you don’t have a list readily available, you can ask your employer.
If your employer does not provide care through a network, you can either talk to your primary care provider and ask if they treat workers’ comp patients, or you can find a doctor online.
What benefits am I entitled to on workers’ compensation?
If you’re injured on the job, workers’ compensation insurance provides medical care, which is paid for by your employer to help you recover from your injury.
You can also receive benefits for temporary disability, permanent disability, and supplemental job displacement, depending on the severity and length of your injury. Death benefits are also available if a worker is killed.
When can I return to work after an injury?
As soon as you’re cleared by your doctor, employer, and claims administrator, you can return back to work. If a doctor decides you cannot return to work while recovering from your injuries, you can’t be forced to go back to work.
However, a doctor can send you back to your job with work restrictions if your employer is able to make accommodations. Depending on your injuries, you may be eligible for any number of disability benefits while you recover.
Do I need an attorney to assist me with my workers’ comp claim?You’re not required to have an attorney for a workers’ comp claim, however, one may be beneficial under certain circumstances. If your employer denies your claim, you settlement offer doesn’t cover all your medical bills, or your boss retaliates against you for filing a claim, it’s important to enlist legal guidance.
Do I get paid if I can’t work because of a work injury?
Depending upon whether or not the injury is initially accepted, if the case is not initially accepted, you will likely be in the position to request state disability through EDD. If the injury is immediately accepted by the insurance company, you will receive a similar amount through the insurance company from a benefit called temporary disability (TTD) benefits.
Interestingly, while EDD benefits/SDI can last up to one year, TTD benefits can last up to two years.
Can I be fired for filing a workers’ compensation claim?“…California Labor Code §132(a) provides strict protection for employees against employers who discriminate or retaliate against them for filing a workers’ compensation claim. A violation of this rule can result in significant penalties against the employer…”