| Dental Plans Applications |
| Anthem Blue Cross of California |
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| Blue Shield |
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| Delta Dental MorganWhite |
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| Golden West |
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| Kaiser Permanente |
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| Standard Life MorganWhite |
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Home Worker Pension California
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WORKERS PENSION CALIFORNIA |
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Almost every employed Californian is protected by workers'
compensation for job related injuries or illness. Therefore it's important
that both employer and employees understand workers' compensation insurance.
This guide provides general information on workers'
compensation insurance and offers suggestions on where to seek help
with a question or problem (see listings of exhibits I, II and III).
MOST FREQUENTLY ASKED QUESTIONS ABOUT WORKERS
COMPENSATION
Q. What is covered under a workers' compensation
insurance policy?
A. The workers' compensation insurance
policy includes two separate coverages: workers' compensation and employers
liability. The workers' compensation coverage applies to injury or disease
to the employee resulting from employment. The insurance company will
pay benefits to the employee specified under the law. Employers liability
coverage protects the employer for employee work-related bodily injury
which is not compensable under workers' compensation coverage.
Q. What are workers' compensation benefits?
A. Depending on the circumstances
of the accident and/or the injury, employees may be entitled to one
or more of the following benefits:
Medical Care: All medical treatment
necessary to cure or relieve the effects of a work-related injury or
illness will be paid either by the employer or the insurance company
providing coverage. This includes physician services, hospitalization,
physical restoration, dental care, prescriptions, X-rays, laboratory
services, and all other necessary/reasonable care ordered by the treating
doctor(s).
Temporary Disability (TD) Paid if a physician verifies
that an injured employee cannot work because of a work-related illness
or injury. TD benefits are not paid for the first 3 days of work missed
unless the employee is off more than fourteen days or hospitalized.
The amount of TD compensation is determined by law and is two thirds
of the employee's wages with a minimum of $126.00 per week (or the actual
weekly wage if that is less than $126.00) and a maximum of $490.00 per
week. Payments must be made every two weeks, for as long as the employee
is eligible. TD benefits stop when the employee returns to work or the
treating physician releases the employee for work or says that the injury
has reached a point of maximum improvement.
Permanent Disability (PD) Paid if an injury or illness
results in a permanent impairment that reduces the injured workers ability
to compete in the open labor market. The amount he employee will receive
depends on the extent of the disability. Other factors that are considered
when calculating PD include the date of injury, the age when injured,
and occupation. PD benefit amounts are set by law. PD benefits are paid
every two weeks until the benefit is completely paid or when the employee
settles the case and receives a lump sum (See exhibit III for maximum
benefit rates.)
Vocational Rehabilitation (VR) Paid if it is unlikely
a worker will be able to return to the usual job prior to his/her injury
and the employer does not offer other work. Vocational Rehabilitation
Maintenance Allowance benefits (VRMA) are paid while the employee is
participating in vocational rehabilitation. VRMA is paid every two weeks
for as long as the employee is eligible. The Division of Workers' Compensation,
Rehabilitation Unit, must approve the rehabilitation plan. The right
to rehabilitation is voluntary; injured workers may accept or reject
this benefit. For injuries occurring on or after January 1, 1994, there
is a $16,000.00 limit on all rehabilitation benefits.
Transportation Reimbursement Paid by the insurance
carrier or employer for the reasonable cost of transportation incurred
while obtaining medical care and rehabilitation. The injured worker
is entitled to mileage from their home to place of treatment, examination
or rehabilitation and back at the rate of 31 cents per mile.
Death Benefits Paid to qualified surviving dependents
of a worker who dies from a work-related illness or injury. These benefits
are paid usually at the same weekly rate as the maximum TD benefit in
effect at the time of injury/illness. The maximum benefit will vary
depending on the number of total and/or partial dependents.
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| Standard Health Plans Applications |
| Aetna |
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| Anthem BC Life and Health Insurance Company Tonik |
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| Anthem Blue Cross of California |
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| Blue Shield of California |
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| Health Net of California |
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| Health Net of California Farm Bureau |
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| Kaiser Permanente |
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| Temporary Health Plans Applications |
| Anthem BC Life and Health Insurance Company |
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| Assurant |
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| Health Net of California |
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| Health Plans |
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