California law states that all employers are required to maintain workers’ compensation insurance. Failure to do so makes a business vulnerable to penalties and fines.
When employees suffer injuries on the job, they usually file claims for workers’ compensation. Once filed, employees receive payment in lieu of the wages they would have received. In addition, employees are entitled to medical treatment at no cost to them.
Workers’ compensation insurance companies administer benefits to injured employees on behalf of their client employers. The insurance companies employ adjusters, investigators, lawyers and doctors to determine the protocol and value of claims made by employees. When an employee makes a large claim, he or she typically retains an attorney specializing in employee workers’ compensation claims to fight the insurance company. Employers usually approve of their insurance company being aggressive because successful claims made by its employees often result in higher insurance premiums.
Sometimes workers’ compensation claims turn into legal battles because insurance companies perceive that employee’s, and their attorneys, may pursue excessive or even fraudulent claims. The term malingerer describes an “injured” worker who exaggerates his or her injuries to attempt to receive additional compensation and/or time off from work. Insurance companies, however, rarely fight minor claims such as a broken finger.
By law, employers must visibly post their employees’ rights concerning workers’ compensation benefits and the name of their insurance carrier. The State Department of Industrial Relations or the California Chamber of Commerce can help guide you to ensure you are following state guidelines correctly. You can order pre-printed copies of postings via e-mail, posting@dir.ca.gov, or by calling 415-703-5070.
Determining who provides medical care after an injury isn’t so simple. Under California law, employers are entitled to make the initial selection of physicians. The employee, however, can change to his own physician after 30 days unless the employer or their insurance company has established a medical provider network. On the other hand, employees have the right to provide their employer with written notification that they have a personal physician and wish treatment by that physician for work-related injuries. The right to be treated by one’s own physician at the outset of injury is valid in this case and also if the employer has failed to post notice of workers’ compensation rights as required by law.
If you are shopping for workers’ compensation insurance, beware of unusually inexpensive coverage rates. To avoid hefty fines and penalties, verify that the insurer is authorized by the State of California prior to making a commitment. Call the California Department of Insurance’s hotline at 1-800-927-4357.
If you are an employer and have additional questions concerning workers’ compensation, feel free to contact my office.
Gregg L. Goodman, LUTCF is the CEO of the Gregg L. Goodman Insurance Agency, Inc. He is an agent for Farmers Insurance and provides life, health, homeowners and auto insurance, as well as commercial insurance programs. For more information, you can reach him at 661-254-6739.