Pallavi Saitu - Practicum Worker's Compensation in California

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Workers’ Compensation In California:

Workers’ Compensation In California Pallavi Saitu Employment Law Prof. Tom Cushing

Objectives :

Objectives History of Workers’ Compensation What is meant by Workers’ Compensation Laws and regulations Types of Injuries Workers' Comp: Employers’ Role Benefits of Workers’ Compensation The Effect of Returning to Work Eligible Employees Wage Loss Benefits  Major issues New proposals

History of Workers’ Compensation:

Introduced by state governments between 1910 and 1920. First widespread social insurance program in U.S. history. These programs are sponsored by the state government . When there is an unforeseen event the employee is required to pay for nearly all of the medical costs of the accident and to replace up to two-thirds of the workers' lost earnings. The federal government, in various combinations with state and local governments, offers unemployment insurance, social security, aid to families with dependent children, food stamps, Medicare, Medicaid, supplemental security income, and subsidies for housing and other basic needs. History of Workers’ Compensation

Workers’ Compensation :

If you are hurt on the job(injured or becomes ill due to work related activities), the employer is required under the law to provide compensation and medical benefits. Worker’s compensation is an employer-paid benefit program. Workers’ Compensation


Laws and regulations Article XIV , Section 4 Title 8 of California Code of Regulations (CCR) State Personnel Board (SPB) California Department of Human Resources ( CalHR ) State Administrative Manual (SAM )


Does it apply to you Applies as per the state Workers ' compensation insurance Employee type Under the CA Law CA Labor Code Division 3, section 2700 through Division 4.7, section 6208 Every person in the service of an employer under any appointment or contract of hire or apprenticeship, express or implied, oral or written ,whether lawfully or unlawfully employed. Domestic employees employed by his or her parent, spouse, or child Deputy sheriffs or deputy Persons performing services in return for aid or sustenance only Persons officiating Amateur sporting events (intercollegiate or interscholastic sports events) Any person performing voluntary services at or for a non-profit recreational camp or as a ski patroller Laws and regulations


Work related injury Preexisting injuries at the workplace Injuries caused during breaks, lunch hours, work sponsored activities Specific diseases such as lung cancer, caused by exposure to toxins in workplace Injuries occurred due to mental and physical strain Injuries not covered by worker’s compensation Intoxicated Deliberately inflects injury on self Personal errand Types of Injuries


Claim FORM Example


Responsibilities Purchase insurance for employees Other States –self-insurance Penalties Fines Criminal prosecution Personal liability of the employer sue the employer instead of a compensation claim. Workers’ Comp: Employers’ Role


Medical Care Temporary Disability Permanent Disability Supplemental job displacement (SJDB) benefits Death Benefits Return-to-work supplement Benefits of Workers’ Compensation


TD Benefits for injuries on or after 1/1/15 Average Weekly earning Below $248.24 $248.24-$1,654.94 Above $1,654.94 Temporary disability rate $165.49 2/3xAverage Weekly Wage $ 1,103.29


T he employee receives wages equal to or greater than he or she was earning prior to the injury, then it is likely workers' compensation benefits will be stopped . However , the employee is still experiencing a wage loss due to his or her injury, he or she may continue to receive wage loss benefits, although the benefits will most likely be for a lesser amount . The Effect of Returning to Work


Works for a covered employer. Employer for a minimum of 12 months, worked at least 1,250 hours during those 12 months J ob that takes place in a location where at least 50 employees work or within 75 miles of such a location Eligible Employees


Temporary Partial experienced a work injury and is temporarily disabled Temporary Total payable to injured employees who are temporarily prohibited from working. Wage Loss Benefits 


Rising Generic Drug Prices Medical Treatment Guidelines The Evolving Healthcare Model The Need for Integrated Disability Management Major issues


New legislator passed in 2015 Undocumented Workers; UEBTF; SIBTF . Prescription Drug Formulary . Notices in Additional Languages . Medical Provider Networks . Home Health Care Payment Schedule. New proposals


Young, J. (2015, July 12 ). California Workers’ Compensation: 2015 Year in Review. Retrieved from https:// Workers ’ compensation. ( n.d. ). Retrieved from / Goldberg, S. (2016, October 04 ). Employers get ready for comp changes. Retrieved from References


SB-863 Workers’ compensation. (2011). Retrieved from https :// Background leading to workers’ compensation reforms. ( n.d. ). Retrieved from'%20Compensation%20System%20in%20California.pdf Walls, M. (2015, January 05). Workers’ comp issues to watch in 2015. Retrieved from References