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Q. Who decides where an injured employee receives
medical treatment?
A. The employer is responsible for
arranging medical treatment for the first 30 days from the date of injury.
If, prior to an injury or illness, an employee gives written notice
to the employer selecting a personal physician, then the employee may
go to this physician for treatment immediately after an injury.
Q. Where can employees or employers get more
information concerning workers' compensation benefits?
A. Questions about the workers' compensation
laws, claims process and/or benefits should be directed to an Information
and Assistance Officer at one of the district offices of the Division
of Industrial Accidents, Department of Industrial Relations. (See Exhibit
I for a list of the district offices).
Q. What happens if an employee disagrees with
the insurance company on a workers' compensation claim denial?
A. The employee may request assistance
from an Information and Assistance Officer who will attempt to help
resolve the dispute informally. If that effort fails, the employee can
file an application for adjudication with the Workers' Compensation
Appeals Board,
(WCAB). The Information and Assistance Officer may be able to assist
with this filing unless the injured worker has retained a private attorney.
The WCAB has exclusive jurisdiction for resolution of the dispute.
Q. As a sole employer or the sole owner/employee
of a business, can I obtain workers' compensation insurance to cover
myself?
A. Individual employers may be included
for workers' compensation at the option of the insurance company. The
inclusion must be clearly stated in the policy, or by an endorsement
to the policy. If an individual employer is included, the remuneration
earned by such a person during the policy period will be used as the
basis of premium development, subject to a specified minimum and maximum.
The California Workers' Compensation Uniform Statistical Reporting Plan-1995,
published by the Workers' Compensation Insurance Rating Bureau (WCIRB)
effective January 1, 1995, establishes minimum remuneration of $22,100
and a maximum of $62,400 for this situation (Note: with Open Rating
each insurer can establish its own minimum and maximum remuneration
and file same with the CDI).
Q. What is my status as an active partner in
a business described as a partnership? Does the policy provide coverage
for me in this situation?
A. The definition of employee includes
all working members of a partnership receiving wages irrespective of
the profits from the partnership. The California Labor Code has a special
provision for partners. You should refer to the policy provisions and/or
consult
with your agent or broker and insurer for the further details.
Q. Are executive officers covered under the
workers' compensation policy?
A. The inclusion of all corporate
officers or directors is mandatory unless the corporation is solely
owned by the directors and executive officers. In the latter case, the
officers and directors may elect to be excluded from coverage. Again,
because of special provisions in the Labor Code for executive officers
of solely owned corporations, consult with the agent, broker and insurer
for further details.
Q. What happens if my employer does not carry
Workers' Compensation Insurance?
A. You may be able to file a claim
with the Uninsured Employers Fund, (U.I.F.). This Fund is located within
the Department of Industrial Relations. You should contact Information
and Assistance Officer for help in pursuing a claim with U.I.F.
Q. As an employer, where can I obtain workers'
compensation insurance?
A. You can secure workers' compensation
insurance from any licensed insurance company that writes this coverage
in California. You may also obtain the required coverage from the State
Compensation Insurance Fund. Consult your local Yellow Pages under Insurance
for names of companies, agents or brokers offering coverage.
workers pension
california | kaiser workers
pension | health
insurance workers pension|
worker pension
health net | PPO plans workers
pension | kaiser
group plans workers pension |
Blue cross
workers pension | HMO plans
workers pension | Pacificare
workers pension |
Blue shield
workers pension
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